=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639249873
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JEFFREY S PARTON
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2006
-----------------------------------------------------
Last Update Date | 05/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3236 78TH AVE SE
-----------------------------------------------------
City | MERCER ISLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98040-3500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-232-6653
-----------------------------------------------------
Fax | 206-232-6654
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3236 78TH AVE SE STE 100
-----------------------------------------------------
City | MERCER ISLAND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98040-3500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-232-6653
-----------------------------------------------------
Fax | 206-232-6654
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | WALIC#CH000338
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------