MEDICARE: CARPENTER HEALTH PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	363LP2300X	Primary Care Nurse Practitioner
3	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1427776319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARPENTER HEALTH PLLC

Provider Business Mailing Address
First Line	:	1268 BRIDGE ST
Second Line	:
City	:	CLARKSTON
State	:	WA
Zip	:	99403-2219
Country	:	US
Telephone Number	:	509-758-9524
Fax Number	:	509-758-8258

Provider Business Practice Location Address
First Line	:	1268 BRIDGE ST
Second Line	:
City	:	CLARKSTON
State	:	WA
Zip	:	99403-2219
Country	:	US
Telephone Number	:	509-758-9524
Fax Number	:	509-758-8258

Authorized Official
Title or Position	:	OWNER
Name	:	TODD CARPENTER
Credential	:	NP
Telephone Number	:	509-758-9524

Provider Enumeration Date	:	08/17/2022
Last Update Date	:	07/18/2023

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Directions to “CARPENTER HEALTH PLLC ” Practice Location

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