Provider Demographics
NPI:1396389714
Name:PARKER, LINDA LEE
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LEE
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 PALMER DR N
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-7424
Mailing Address - Country:US
Mailing Address - Phone:503-990-7900
Mailing Address - Fax:
Practice Address - Street 1:468 PALMER DR N
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-7424
Practice Address - Country:US
Practice Address - Phone:503-990-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider