Provider Demographics
NPI:1851685796
Name:PARKER, GINGER M (LMP)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:M
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 1:5009 W CLEARWATER AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-4986
Mailing Address - Country:US
Mailing Address - Phone:509-554-3244
Mailing Address - Fax:
Practice Address - Street 1:5009 W CLEARWATER AVE
Practice Address - Street 2:SUITE F
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-4986
Practice Address - Country:US
Practice Address - Phone:509-554-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023143225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist