MEDICARE: KARRIE M FOX D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OP00001990	WA

General Provider Information

NPI Number	:	1164645487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARRIE M FOX D.O.

Provider Business Mailing Address
First Line	:	2960 LIMITED LN NW STE A
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4541
Country	:	US
Telephone Number	:	360-709-9500
Fax Number	:	360-754-4517

Provider Business Practice Location Address
First Line	:	2960 LIMITED LN NW STE A
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-4541
Country	:	US
Telephone Number	:	360-709-9500
Fax Number	:	360-754-4517

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	03/27/2010

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