Individual
MRS. KENDALL PARKS
Active
Individual
MRS. KENDALL PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
532
MT
363AM0700X
Medical Physician Assistant
PA10004623
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780781500
—
MT
Enumeration date
09/20/2006
Last updated
06/22/2026
Update your record
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