Healthcare Provider Details

I. General information

NPI: 1114942232
Provider Name (Legal Business Name): CHERYL PARKER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER 4800 SAND POINT WAY NE M/S W7706
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

11550 STONE AVE N 204
SEATTLE WA
98133-1513
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-1272
  • Fax:
Mailing address:
  • Phone: 206-985-8883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA10004200
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: