Provider Demographics
NPI:1922644046
Name:PARKER, FLETCHER (DC)
Entity Type:Individual
Prefix:DR
First Name:FLETCHER
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 NE 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1941
Mailing Address - Country:US
Mailing Address - Phone:503-389-5545
Mailing Address - Fax:
Practice Address - Street 1:1359 NE 35TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1941
Practice Address - Country:US
Practice Address - Phone:503-389-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-24
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor