Healthcare Provider Details

I. General information

NPI: 1134282130
Provider Name (Legal Business Name): DEBORAH DARLENE PARKS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH D ALLEN

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 01/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 29TH ST SE
AUBURN WA
98002-7541
US

IV. Provider business mailing address

1600 E OLIVE ST SEATTLE MENTAL HEALTH
SEATTLE WA
98122-2735
US

V. Phone/Fax

Practice location:
  • Phone: 253-876-7650
  • Fax: 253-876-7651
Mailing address:
  • Phone: 206-302-2200
  • Fax: 206-302-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN00128312
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: