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NPI Code Detail

MEDICARE: REBECCA PARKER RN

MEDICARE: REBECCA PARKER RN
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
1163WP0808XPsychiatric/Mental Health Registered Nurse85070423OR

General Provider Information

NPI Number : 1609905546
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA PARKER RN
Provider Business Mailing Address
First Line : 14600 NW CORNELL RD
Second Line :
City : PORTLAND
State : OR
Zip : 97229-5442
Country : US
Telephone Number : 503-645-3581
Fax Number : 503-533-0152
Provider Business Practice Location Address
First Line : 971 SW WALNUT ST
Second Line :
City : HILLSBORO
State : OR
Zip : 97123-5651
Country : US
Telephone Number : 503-640-5297
Fax Number : 503-640-5780
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/08/2007

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