Provider Demographics
NPI:1922439470
Name:SIEGLINDE PARKER
Entity type:Organization
Organization Name:SIEGLINDE PARKER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SIEGLINDE
Authorized Official - Middle Name:GLORIA
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:253-333-3605
Mailing Address - Street 1:11013 111TH ST SW
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98498-1328
Mailing Address - Country:US
Mailing Address - Phone:253-359-0840
Mailing Address - Fax:
Practice Address - Street 1:17813 SE 392ND ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-9126
Practice Address - Country:US
Practice Address - Phone:253-333-3605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60010863261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder