Healthcare Provider Details

I. General information

NPI: 1871858266
Provider Name (Legal Business Name): CARA SOMMER CRAM DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 NE 139TH ST STE 200
VANCOUVER WA
98686-2742
US

IV. Provider business mailing address

2211 NE 139TH ST STE 200
VANCOUVER WA
98686-2742
US

V. Phone/Fax

Practice location:
  • Phone: 360-487-1777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number06813
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT60176785
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: