MEDICARE: CURTIS ZANE PARKE

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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1750978508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS ZANE PARKE

Provider Business Mailing Address
First Line	:	231 LYON ST SE
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97321-2707
Country	:	US
Telephone Number	:	541-791-3411
Fax Number	:

Provider Business Practice Location Address
First Line	:	456 SW MONROE AVE STE 108
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97333-7207
Country	:	US
Telephone Number	:	541-791-3411
Fax Number	:

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

Provider Enumeration Date	:	12/28/2020
Last Update Date	:	12/28/2020

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Directions to “ CURTIS ZANE PARKE ” Practice Location

Language	Start Address	Practice Location

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