Provider Demographics
NPI:1730801440
Name:PARSON, MICHELLE MARIE (CNA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:PARSON
Suffix:
Gender:F
Credentials:CNA
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:120-879-1238
Mailing Address - Fax:
Practice Address - Street 1:1556 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1150
Practice Address - Country:US
Practice Address - Phone:208-791-2386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60316855374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA18421297OtherNON MEDICAL