Provider Demographics
NPI:1992044051
Name:PARKER, CAMILLE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 HOLLY DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-2607
Mailing Address - Country:US
Mailing Address - Phone:425-366-2500
Mailing Address - Fax:425-366-2502
Practice Address - Street 1:9600 HOLLY DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-2607
Practice Address - Country:US
Practice Address - Phone:425-366-2500
Practice Address - Fax:425-366-2502
Is Sole Proprietor?:No
Enumeration Date:2013-02-10
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60302136247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other