MEDICARE: MS. CARRIE A CHAMBERS PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251N0400X	Neurology Physical Therapist
2	2251P0200X	Pediatric Physical Therapist
3	225100000X	Physical Therapist	PT00007637	WA

General Provider Information

NPI Number	:	1265451538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARRIE A CHAMBERS PT

Provider Business Mailing Address
First Line	:	6632 SW LUANA BEACH RD
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-7222
Country	:	US
Telephone Number	:	206-459-7724
Fax Number	:

Provider Business Practice Location Address
First Line	:	6632 SW LUANA BEACH RD
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-7222
Country	:	US
Telephone Number	:	206-459-7724
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	12/29/2018

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