Provider Demographics
NPI:1972604213
Name:PARRISH, REBECCA L (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:PARRISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1409
Mailing Address - Country:US
Mailing Address - Phone:425-317-0279
Mailing Address - Fax:425-317-0291
Practice Address - Street 1:4430 106TH ST SW
Practice Address - Street 2:SUITE 102
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-4711
Practice Address - Country:US
Practice Address - Phone:425-347-6686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040419207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8313835Medicaid
WAG8878065Medicare PIN
WAG8852313Medicare PIN
WA8313835Medicaid