Healthcare Provider Details

I. General information

NPI: 1184366163
Provider Name (Legal Business Name): TARALYNN CARTER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2022
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 JAMES ST
SEATTLE WA
98104-5102
US

IV. Provider business mailing address

216 JAMES ST
SEATTLE WA
98104-5102
US

V. Phone/Fax

Practice location:
  • Phone: 206-464-6454
  • Fax:
Mailing address:
  • Phone: 206-464-6454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: