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General NPI Number Information
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NPI Number | 1669366324
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Entity Type | Individual
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Provider Name | CARLY KLEIBER CPO
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Gender | Female
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 2621 NE 134TH ST STE 120
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City | VANCOUVER
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State | WA
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Zip | 98686-3036
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Country | US
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Telephone | 360-574-5452
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Fax |
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Provider Business Mailing Address
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Address Line | 2621 NE 134TH ST STE 120
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City | VANCOUVER
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State | WA
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Zip | 98686-3036
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Country | US
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Telephone | 360-574-5452
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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 | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | PS61583072
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | OI61431449
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License Number State | WA
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