Healthcare Provider Details

I. General information

NPI: 1821928292
Provider Name (Legal Business Name): CARSON DRAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3723 60TH AVE SW
SEATTLE WA
98116-3025
US

IV. Provider business mailing address

3723 60TH AVE SW
SEATTLE WA
98116-3025
US

V. Phone/Fax

Practice location:
  • Phone: 904-994-1518
  • Fax:
Mailing address:
  • Phone: 904-994-1518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: