Healthcare Provider Details

I. General information

NPI: 1265451538
Provider Name (Legal Business Name): CARRIE A CHAMBERS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6632 SW LUANA BEACH RD
VASHON WA
98070-7222
US

IV. Provider business mailing address

6632 SW LUANA BEACH RD
VASHON WA
98070-7222
US

V. Phone/Fax

Practice location:
  • Phone: 206-459-7724
  • Fax:
Mailing address:
  • Phone: 206-459-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00007637
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: