Provider Demographics
NPI:1992027635
Name:PARKS, DEVON ALEXIS (PA-C)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:ALEXIS
Last Name:PARKS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:74B CENTENNIAL LOOP
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7918
Mailing Address - Country:US
Mailing Address - Phone:541-686-3791
Mailing Address - Fax:541-686-3795
Practice Address - Street 1:74B CENTENNIAL LOOP
Practice Address - Street 2:SUITE 100
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7918
Practice Address - Country:US
Practice Address - Phone:541-686-3791
Practice Address - Fax:541-686-3795
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-08-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant