Provider Demographics
NPI:1396135554
Name:PARR, MEREDITH A (PA-C)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:A
Last Name:PARR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 17TH AVE NW STE 1799
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5232
Mailing Address - Country:US
Mailing Address - Phone:206-590-1506
Mailing Address - Fax:206-238-9360
Practice Address - Street 1:5608 17TH AVE NW STE 1799
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5232
Practice Address - Country:US
Practice Address - Phone:206-590-1506
Practice Address - Fax:206-238-9360
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60637500363A00000X, 363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2060064Medicaid
NC1396135554Medicaid
WA1396135554Medicaid
WA8955130Medicare PIN
NCNCN080BMedicare PIN
WA1396135554Medicaid
NCNCN080AMedicare PIN
SC2189PAMedicaid