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1891791232

NPI Code Detail

MEDICARE: CLARK O. PARRISH M.D.

MEDICARE: CLARK O. PARRISH M.D.

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	207R00000X	Internal Medicine Physician	MD188136	OR
2	207R00000X	Internal Medicine Physician	MD00024849	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4587184	OTHER	WA	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	12304	OTHER	WA	REGENCE
4	0230044	OTHER	WA	L&I AND CRIME VICTIMS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891791232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARK O. PARRISH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 5096
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98227-5096
Country	:	US
Telephone Number	:	360-738-2200
Fax Number	:	360-715-2486

Provider Business Practice Location Address
First Line	:	4545 CORDATA PKWY
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-7123
Country	:	US
Telephone Number	:	360-738-2200
Fax Number	:	360-715-2486

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	03/29/2019

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Directions to “ CLARK O. PARRISH M.D.” Practice Location

Language	Start Address	Practice Location

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