Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3589 | OR |
NPI | 1003977448 |
---|---|
Provider Name | Dr. William A Parker |
First Address | Clackamas, OR 97015-9025 |
Second Address | Clackamas, OR 97015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 18/07/2018 |