Healthcare Provider Details

I. General information

NPI: 1275289498
Provider Name (Legal Business Name): CARMEN GAIL DOOLEY PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 5TH ST STE 150
WENATCHEE WA
98801-6649
US

IV. Provider business mailing address

1 5TH ST STE 150
WENATCHEE WA
98801-6649
US

V. Phone/Fax

Practice location:
  • Phone: 509-816-4070
  • Fax: 509-267-2779
Mailing address:
  • Phone: 509-816-4070
  • Fax: 509-267-2779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number60100406
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: