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General NPI Number Information
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NPI Number | 1194643726
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Entity Type | Individual
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Provider Name | JESSICA ALIZ PARKS SR.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2026
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Last Update Date | 07/09/2026
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Provider Practice Location Address
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Address Line | 2100 24TH AVE S STE 200
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City | SEATTLE
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State | WA
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Zip | 98144-4643
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Country | US
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Telephone | 206-767-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 140 23RD AVE S APT 303
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City | SEATTLE
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State | WA
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Zip | 98144-4364
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Country | US
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Telephone | 206-271-1867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | WA
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