Individual
SUMMERA PARCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 101, MILWAUKIE, OR 97222-4628
(971) 206-5202
Mailing address
61 E COON DR N, BELFAIR, WA 98528-9197
(619) 251-8197
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
P1 60735754
WA
Other
Enumeration date
04/28/2017
Last updated
04/28/2017
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