Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH00034218 | WA |
N | 111NR0400X | Rehabilitation Chiropractor | CH00034218 | WA |
NPI | 1346463007 |
---|---|
Provider Name | Dr. James R Carpenter |
First Address | Redmond, WA 98052 |
Second Address | Redmond, WA 98052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 15/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8806681 | PPIN (01) | WA |
V01184 | (02) |