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General NPI Number Information
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NPI Number | 1144818980
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Entity Type | Individual
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Provider Name | CAROLINE OWENS
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Gender | Female
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 9215 29TH ST NE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-4200
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Country | US
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Telephone | 425-335-1643
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Fax |
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Provider Business Mailing Address
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Address Line | 23620 3RD PL W
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City | BOTHELL
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State | WA
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Zip | 98021-8690
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Country | US
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Telephone | 425-985-8381
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | P160268704
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License Number State | WA
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