Healthcare Provider Details

I. General information

NPI: 1033770755
Provider Name (Legal Business Name): LAUREN TAYLOR PARRISH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 06/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW # 2PHC
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

16925 CARMICHAEL PL
PURCELLVILLE VA
20132-9657
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-3700
  • Fax:
Mailing address:
  • Phone: 540-539-4423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA031587
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: