Provider Demographics
NPI:1194968586
Name:PARKER, KEA A (MD)
Entity type:Individual
Prefix:
First Name:KEA
Middle Name:A
Last Name:PARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3303 SW BOND AVE.
Mailing Address - Street 2:OHSU FAMILY MEDICINE CENTER FOR HEALTH AND HEALING
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-494-8573
Mailing Address - Fax:503-494-3457
Practice Address - Street 1:3303 SW BOND AVE
Practice Address - Street 2:OHSU FAMILY MEDICINE CENTER FOR HEALTH AND HEALING
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4501
Practice Address - Country:US
Practice Address - Phone:503-494-8573
Practice Address - Fax:503-494-3457
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR174235207Q00000X
CAA123497207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine