Provider Demographics
NPI:1275621658
Name:PARKER, MAUREEN ROSE (MS, ATC, LMP, CES)
Entity Type:Individual
Prefix:MISS
First Name:MAUREEN
Middle Name:ROSE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS, ATC, LMP, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 212TH ST SW STE 101
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7614
Mailing Address - Country:US
Mailing Address - Phone:425-776-6966
Mailing Address - Fax:425-776-6969
Practice Address - Street 1:7500 212TH ST SW
Practice Address - Street 2:STE 116
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7641
Practice Address - Country:US
Practice Address - Phone:425-776-6966
Practice Address - Fax:425-776-6969
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0304021382255A2300X
WAMA00022740225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer