Provider Demographics
NPI:1063988863
Name:PARKER, ARKAR (AAC)
Entity type:Individual
Prefix:
First Name:ARKAR
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 4TH AVE S STE 230
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5907
Mailing Address - Country:US
Mailing Address - Phone:206-643-7427
Mailing Address - Fax:253-398-2177
Practice Address - Street 1:124 4TH AVE S STE 230
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5907
Practice Address - Country:US
Practice Address - Phone:253-246-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60776335101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health