Healthcare Provider Details

I. General information

NPI: 1114922853
Provider Name (Legal Business Name): JOHN WILLIAM PARMELEE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2005
Last Update Date: 11/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2153 SHY BEAR WAY NW APT 411
ISSAQUAH WA
98027-5630
US

IV. Provider business mailing address

2153 SHY BEAR WAY NW APT 411
ISSAQUAH WA
98027-5630
US

V. Phone/Fax

Practice location:
  • Phone: 206-369-0555
  • Fax:
Mailing address:
  • Phone: 235-631-4960
  • Fax: 253-630-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number473
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: