Individual
KIRK JOSEPH PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1517 SW MARLOW AVE, PORTLAND, OR 97225-5101
(503) 292-5221
(503) 297-3937
Mailing address
1517 SW MARLOW AVE, PORTLAND, OR 97225-5101
(503) 292-5221
(503) 297-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1936ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
891185001
BLUE CROSS
—
Enumeration date
05/03/2006
Last updated
11/21/2007
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