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General NPI Number Information
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NPI Number | 1598964462
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Entity Type | Individual
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Provider Name | PHILIP D PARKER R.N.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 21601 76TH AVENUE WEST
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City | EDMONDS
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State | WA
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Zip | 98026
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Country | US
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Telephone | 425-640-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 3415 159TH PLACE SOUTHEAST
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City | MILL CREEK
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State | WA
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Zip | 98012
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Country | US
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Telephone | 425-338-9194
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN00142701
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License Number State | WA
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