Parkside Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH 1307 Issued in WA

Legal business name

PARKSIDE HEALTHCARE LLC

Practice address

1230 Monitor St
Wenatchee, WA 98801-3534

Phone

(509) 662-1636

Fax

(509) 662-8690

NPI assigned

Sep 14, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Diana V Wiley

Title

Controller

Phone

(509) 662-1636

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457346512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 OKANOGAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988016409",
            "telephone_number": "509-662-1636",
            "fax_number": "509-662-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 MONITOR ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013534",
            "telephone_number": "509-662-1636",
            "fax_number": "509-662-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "509-662-1636",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH 1307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113072",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jungwon Genevieve Park, M.D., PH.D.
• Siyeon Park, RPH
• Katelyn Jackie Parker, LMP
• David Walker Parks, D.M.D.
• Emily Anne Carolina Parks, LMFTA
• Michael A Parnell, MD
• Sara E. Parnell, ARNP
• Marika K Parrish, DPT
• Mary Parrish, RN
• Mitchell Parrish

• Skilled Nursing Facility in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.