Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 1495 | OR |
Y | 225100000X | Physical Therapist | PT60218853 | WA |
N | 2251S0007X | Physical Therapist - Sports | 1495 | OR |
N | 2251S0007X | Physical Therapist - Sports | PT 60218853 | WA |
NPI | 1134412141 |
---|---|
Provider Name | Mrs. Barbara Jo Carter |
First Address | Portland, OR 97208-3158 |
Second Address | Vancouver, WA 98683-1443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 16/04/2019 |