Provider Demographics
NPI:1427149111
Name:PARKIN, PAUL GRAY (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:GRAY
Last Name:PARKIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 SEDONA DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8195
Mailing Address - Country:US
Mailing Address - Phone:509-544-0794
Mailing Address - Fax:
Practice Address - Street 1:1410 W 27TH AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-3701
Practice Address - Country:US
Practice Address - Phone:509-585-0846
Practice Address - Fax:509-585-0847
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00010140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist