Provider Demographics
NPI:1790779650
Name:PARKER, KAREN CHRISTINE (CNM)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:CHRISTINE
Last Name:PARKER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:PARKER
Other - Last Name:LINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:847 NE 19TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2684
Mailing Address - Country:US
Mailing Address - Phone:503-963-2801
Mailing Address - Fax:503-963-2825
Practice Address - Street 1:5050 NE HOYT ST
Practice Address - Street 2:SUITE 353
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2991
Practice Address - Country:US
Practice Address - Phone:503-239-6800
Practice Address - Fax:503-239-0006
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR89000486363LX0001X
OR089000486N5363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR065164Medicaid
WA2040174Medicaid
WA2040174Medicaid
OR065164Medicaid
OR177071Medicare PIN