Provider Demographics
NPI:1215518246
Name:PARSON, MATTHEW ERIC
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ERIC
Last Name:PARSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1556 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-1150
Mailing Address - Country:US
Mailing Address - Phone:208-791-2535
Mailing Address - Fax:
Practice Address - Street 1:1297 LIBBY ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2551
Practice Address - Country:US
Practice Address - Phone:208-791-2535
Practice Address - Fax:509-295-8534
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide