Doctor Name: | MRS. CARRIE RENE ANDERSON |
NPI Number: | 1518161447 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00023653 |
Business Practice Address: | 19215 Se 34th St. #102 Priority Health Camas, WA - 98607 |
Business Phone Number: | 3608827733 |
Business Fax Number: | 3602546821 |
Mailing Address: | 19215 Se 34th St. #102, Priority Health CAMAS |
State: | WA |
Postal Code: | 98607 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA00023653 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |