Healthcare Provider Details

I. General information

NPI: 1992541940
Provider Name (Legal Business Name): CARA URLACHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 E 1ST ST
PORT ANGELES WA
98362-4012
US

IV. Provider business mailing address

720 N SPENCER FARM PL
SEQUIM WA
98382-3007
US

V. Phone/Fax

Practice location:
  • Phone: 360-912-6759
  • Fax:
Mailing address:
  • Phone: 206-734-9082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number60777103
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: