MEDICARE: DR. MCKENNA F PARNES PHD., MSED

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	103TB0200X	Cognitive & Behavioral Psychologist	PY61391094	WA
2	103TC0700X	Clinical Psychologist	PY61391094	WA
3	103TC2200X	Clinical Child & Adolescent Psychologist	PY61391094	WA

General Provider Information

NPI Number	:	1518820877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MCKENNA F PARNES PHD., MSED

Provider Business Mailing Address
First Line	:	4256 LINDEN AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-7267
Country	:	US
Telephone Number	:	201-625-5853
Fax Number	:

Provider Business Practice Location Address
First Line	:	4256 LINDEN AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-7267
Country	:	US
Telephone Number	:	201-625-5853
Fax Number	:

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

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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