Provider Demographics
NPI:1952359747
Name:PARKER, LAURA J (MSPT, MTC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSPT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WILLAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3134
Mailing Address - Country:US
Mailing Address - Phone:541-343-8889
Mailing Address - Fax:541-343-9499
Practice Address - Street 1:2675 WILLAMETTE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3134
Practice Address - Country:US
Practice Address - Phone:541-343-8889
Practice Address - Fax:541-343-9499
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4110225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist