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General NPI Number Information
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NPI Number | 1497725469
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Entity Type | Individual
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Provider Name | BETSY L CARLSON M.A., CCC-A
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Gender | Female
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | MADIGAN ARMY MEDICAL CENTER MCHJ-SET-AUDIOLOGY CLINIC
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-968-0456
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Fax | 253-968-5927
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Provider Business Mailing Address
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Address Line | 2202 33RD AVE SE
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City | PUYALLUP
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State | WA
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Zip | 98374-4125
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Country | US
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Telephone |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | WACD00002445
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License Number State | WA
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