Provider Demographics
NPI:1669483871
Name:PARKER, JAMES EARL (LMT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EARL
Last Name:PARKER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5306
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-5306
Mailing Address - Country:US
Mailing Address - Phone:541-330-9003
Mailing Address - Fax:
Practice Address - Street 1:346 NE QUIMBY AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4069
Practice Address - Country:US
Practice Address - Phone:541-330-9003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6823225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist