Provider Demographics
NPI:1942489554
Name:PARENT, JOSEPH A JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:PARENT
Suffix:JR
Gender:M
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:PO BOX 8698
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207-8698
Mailing Address - Country:US
Mailing Address - Phone:503-241-1992
Mailing Address - Fax:503-241-1977
Practice Address - Street 1:1750 SW HARBOR WAY
Practice Address - Street 2:SUITE 245
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5128
Practice Address - Country:US
Practice Address - Phone:503-241-1992
Practice Address - Fax:503-241-1977
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD08183207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC93478Medicare UPIN