Healthcare Provider Details

I. General information

NPI: 1316406275
Provider Name (Legal Business Name): KARA MICHELLE MEADER CDPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9045 16TH AVE SW
SEATTLE WA
98106-2355
US

IV. Provider business mailing address

3809 WHITMAN AVE N APT 41
SEATTLE WA
98103-8791
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-7207
  • Fax:
Mailing address:
  • Phone: 704-299-1642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberCO60924595
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: