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NPI Code Detail

MEDICARE: MRS. LAUREN BLAKE PARKER P.T.

MEDICARE: MRS. LAUREN BLAKE PARKER P.T.
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
1225100000XPhysical TherapistPT60582289WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT60582289OTHERWAWASHINGTON PHYSICAL THERAPY LICENSE

General Provider Information

NPI Number : 1477799542
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAUREN BLAKE PARKER P.T.
Provider Business Mailing Address
First Line : PO BOX 1021
Second Line :
City : GIG HARBOR
State : WA
Zip : 98335-3021
Country : US
Telephone Number : 406-671-6343
Fax Number : 253-999-5966
Provider Business Practice Location Address
First Line : 11515 BURNHAM DR
Second Line :
City : GIG HARBOR
State : WA
Zip : 98332-8543
Country : US
Telephone Number : 406-671-6343
Fax Number : 253-999-5966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2008
Last Update Date : 02/25/2025

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