Healthcare Provider Details

I. General information

NPI: 1407790124
Provider Name (Legal Business Name): ASHLEY CARPENTER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21733 SE 288TH ST
BLACK DIAMOND WA
98010-1209
US

IV. Provider business mailing address

21733 SE 288TH ST
BLACK DIAMOND WA
98010-1209
US

V. Phone/Fax

Practice location:
  • Phone: 253-740-7457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.AP.70117198-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: