Individual
DONEEN ETHAZEL PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
905 MAIN ST STE 204, KLAMATH FALLS, OR 97601-6066
(541) 892-9470
Mailing address
905 MAIN ST STE 204, KLAMATH FALLS, OR 97601-6066
Taxonomy
Speciality
Code
Description
License number
State
246YR1600X
Registered Record Administrator
Primary
—
—
Other
Enumeration date
01/03/2023
Last updated
01/03/2023
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