Provider Demographics
NPI:1124224225
Name:PARKER, MOLLY B (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:B
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 SHERIDAN ST
Mailing Address - Street 2:SUITE B103
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-2931
Mailing Address - Country:US
Mailing Address - Phone:360-379-8031
Mailing Address - Fax:360-385-0418
Practice Address - Street 1:915 SHERIDAN ST
Practice Address - Street 2:SUITE B103
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-2931
Practice Address - Country:US
Practice Address - Phone:360-379-8031
Practice Address - Fax:360-385-0418
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00045354207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0237088OtherDEPARTMENT OF LABOR AND INDUSTRIES
WA8947695OtherL&I CRIME VICTIMS
WA5829PAOtherREGENCE
WA8486953Medicaid
WA5829PAOtherREGENCE