Paradise Wound Healing Professionals, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

602411261 Issued in WA

Legal business name

PARADISE WOUND HEALING PROFESSIONALS, PLLC

Practice address

1119 Highland Avenue
Suite 7
Clarkston, WA 99403-2836

Phone

(509) 758-1119

Fax

(509) 758-1140

NPI assigned

Mar 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Alex C Town

Title

Cfo

Phone

(509) 758-4667

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1285750901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994030189",
            "telephone_number": "509-758-1119",
            "fax_number": "509-758-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 HIGHLAND AVENUE",
            "address_2": "SUITE 7",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032836",
            "telephone_number": "509-758-1119",
            "fax_number": "509-758-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE WOUND HEALING PROFESSIONALS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "TOWN",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "509-758-4667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "602411261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "DJVB5",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Maribeth Pallett, RN
• Brindalyn Palmer
• Tawnia Palmer
• Signe Kelsa Parent
• Anthony Parker
• Jeffrey S Parker, CDP
• Sherri J Parker, RN
• Christina Guimaraes Parreira, M.A.

• Specialist in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.