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Individual

SELBY J PARKER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
939 CAROLINE ST, PORT ANGELES, WA 98362-3909
(360) 417-7381
Mailing address
939 CAROLINE ST, PORT ANGELES, WA 98362-3909
(360) 417-7381

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003470
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1709PA
REGENCE BLUE SHIELD RIDER
05
8128357
WA
Enumeration date
03/14/2006
Last updated
07/08/2007
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