Healthcare Provider Details

I. General information

NPI: 1306193354
Provider Name (Legal Business Name): KAI IMANI PARKER N.D., C.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7215 BLAIR RD NW
WASHINGTON DC
20012-1815
US

IV. Provider business mailing address

13121 RIVIERA TER
SILVER SPRING MD
20904-3582
US

V. Phone/Fax

Practice location:
  • Phone: 202-505-5083
  • Fax:
Mailing address:
  • Phone: 202-505-5083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNP-0029
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: