Healthcare Provider Details

I. General information

NPI: 1184087520
Provider Name (Legal Business Name): KATHLEEN APIBUNYOPAS PARKS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN APIBUNYOPAS

II. Dates (important events)

Enumeration Date: 04/02/2016
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 NE 87TH AVE STE 460
VANCOUVER WA
98664-1965
US

IV. Provider business mailing address

505 NE 87TH AVE STE 460
VANCOUVER WA
98664-1965
US

V. Phone/Fax

Practice location:
  • Phone: 360-514-7771
  • Fax: 360-514-7769
Mailing address:
  • Phone: 360-514-7771
  • Fax: 360-514-7769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberMD61173389
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD61173389
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: