Healthcare Provider Details

I. General information

NPI: 1679494991
Provider Name (Legal Business Name): MICHELLE PARKS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 S STONE ST STE 102
SPOKANE WA
99223-4904
US

IV. Provider business mailing address

2807 S STONE ST STE 102
SPOKANE WA
99223-4904
US

V. Phone/Fax

Practice location:
  • Phone: 509-503-1122
  • Fax:
Mailing address:
  • Phone: 509-503-1122
  • Fax: 509-503-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE PARKS
Title or Position: OWNER DENTIST
Credential: DMD
Phone: 509-503-1122