Provider Demographics
NPI:1700375896
Name:PARKWELL, MARY TERESE (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:TERESE
Last Name:PARKWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 GOOD RD
Mailing Address - Street 2:
Mailing Address - City:CAMANO ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98282-8801
Mailing Address - Country:US
Mailing Address - Phone:206-920-5884
Mailing Address - Fax:
Practice Address - Street 1:963 GOOD RD
Practice Address - Street 2:
Practice Address - City:CAMANO ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98282-8801
Practice Address - Country:US
Practice Address - Phone:206-920-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00084205163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse