Provider Demographics
NPI:1417183138
Name:PARKER, HOLLI KRISTINE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLI
Middle Name:KRISTINE
Last Name:PARKER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 164TH ST SE
Mailing Address - Street 2:SUITE N
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-6301
Mailing Address - Country:US
Mailing Address - Phone:425-742-6034
Mailing Address - Fax:425-742-6035
Practice Address - Street 1:800 164TH ST SE
Practice Address - Street 2:SUITE N
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-6301
Practice Address - Country:US
Practice Address - Phone:425-742-6034
Practice Address - Fax:425-742-6035
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024745225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist