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NPI Code Detail

MEDICARE: DANIELLE PARKS

MEDICARE: DANIELLE PARKS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760952956
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE PARKS
Provider Business Mailing Address
First Line : 9324 E MARINGO DR
Second Line :
City : SPOKANE
State : WA
Zip : 99206-4427
Country : US
Telephone Number : 208-691-0395
Fax Number :
Provider Business Practice Location Address
First Line : 1960 N HOLY NAMES CT FL 3
Second Line :
City : SPOKANE
State : WA
Zip : 99224-5803
Country : US
Telephone Number : 509-242-2308
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2018
Last Update Date : 11/29/2018

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Directions to “ DANIELLE PARKS ” Practice Location

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