Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 9782 | NV |
NPI | 1134142813 |
---|---|
Provider Name | Beverly M Parker |
First Address | Spokane, WA 99205-6185 |
Second Address | Spokane, WA 99205-6185 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 09/07/2014 |