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General NPI Number Information
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NPI Number | 1922985092
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Entity Type | Individual
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Provider Name | CARINE AMMONS
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Gender | Female
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 10115 NE 82ND AVE
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City | VANCOUVER
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State | WA
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Zip | 98662-1358
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Country | US
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Telephone | 360-431-6997
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Fax |
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Provider Business Mailing Address
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Address Line | 10115 NE 82ND AVE
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City | VANCOUVER
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State | WA
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Zip | 98662-1358
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Country | US
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Telephone | 360-431-6997
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 605955606-001-0001
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License Number State | WA
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