MEDICARE: JESSICA PARKER RDN, CD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	1018255	WA

General Provider Information

NPI Number	:	1023428307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA PARKER RDN, CD

Provider Business Mailing Address
First Line	:	1700 WESTLAKE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-3012
Country	:	US
Telephone Number	:	206-283-2220
Fax Number	:	206-283-2223

Provider Business Practice Location Address
First Line	:	1700 WESTLAKE AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-3012
Country	:	US
Telephone Number	:	206-283-2220
Fax Number	:	206-283-2223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2014
Last Update Date	:	12/22/2015

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