Provider Demographics
NPI:1588902597
Name:PARKIN, DANICA (ARNP)
Entity type:Individual
Prefix:MS
First Name:DANICA
Middle Name:
Last Name:PARKIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 W BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1626
Mailing Address - Country:US
Mailing Address - Phone:360-528-9669
Mailing Address - Fax:
Practice Address - Street 1:1803 W MAXWELL AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2831
Practice Address - Country:US
Practice Address - Phone:509-483-7535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60327358208D00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8926089OtherMEDICARE PTAN
WA1588902597Medicaid
WA1588902597Medicaid