Provider Demographics
NPI:1114922853
Name:PARMELEE, JOHN WILLIAM (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:PARMELEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2153 SHY BEAR WAY NW
Mailing Address - Street 2:APT 411
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5630
Mailing Address - Country:US
Mailing Address - Phone:235-631-4960
Mailing Address - Fax:253-630-0730
Practice Address - Street 1:2153 SHY BEAR WAY NW
Practice Address - Street 2:APT 411
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5630
Practice Address - Country:US
Practice Address - Phone:206-369-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-18
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA473213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1068618Medicaid
WAU20859Medicare UPIN
WA1068618Medicaid
WA000102233Medicare PIN