MEDICARE: JAMES PARKS

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	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1881016467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES PARKS

Provider Business Mailing Address
First Line	:	116 FAIRVIEW AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-5360
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 FAIRVIEW AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-5360
Country	:	US
Telephone Number	:	206-254-1456
Fax Number	:

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

Provider Enumeration Date	:	01/15/2014
Last Update Date	:	01/15/2014

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Directions to “ JAMES PARKS ” Practice Location

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