Healthcare Provider Details

I. General information

NPI: 1427573229
Provider Name (Legal Business Name): KIMBERLY ANNE PARKER MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY ANNE THORUP

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 NE 137TH AVE
VANCOUVER WA
98682-4933
US

IV. Provider business mailing address

7101 NE 137TH AVE
VANCOUVER WA
98682-4933
US

V. Phone/Fax

Practice location:
  • Phone: 800-813-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLW61106383
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: