MEDICARE: MR. PO KARCZEWSKI ARNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP30005450	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700932050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PO KARCZEWSKI ARNP

Provider Business Mailing Address
First Line	:	9 ST HELENS AVE
Second Line	:	LEVEL B
City	:	TACOMA
State	:	WA
Zip	:	98402-2600
Country	:	US
Telephone Number	:	253-582-9426
Fax Number	:	253-572-2194

Provider Business Practice Location Address
First Line	:	9330 59TH AVE SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-2858
Country	:	US
Telephone Number	:	253-620-5191
Fax Number	:	253-581-2540

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/09/2007

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