Provider Demographics
NPI:1518663897
Name:BUTLER, PARKER JULIAN (AAC, CPC)
Entity Type:Individual
Prefix:
First Name:PARKER
Middle Name:JULIAN
Last Name:BUTLER
Suffix:
Gender:F
Credentials:AAC, CPC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:JENEEN
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 E FOURTH PLAIN BLVD STE A-149
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3713
Mailing Address - Country:US
Mailing Address - Phone:360-206-3671
Mailing Address - Fax:
Practice Address - Street 1:1601 E FOURTH PLAIN BLVD STE A-149
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3713
Practice Address - Country:US
Practice Address - Phone:360-206-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANAMedicaid