Individual
MARISSA PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1017 4TH AVE E, OLYMPIA, WA 98506-4016
(360) 539-7726
(360) 539-7729
Mailing address
1017 4TH AVE E, OLYMPIA, WA 98506-4016
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60829381
WA
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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