Provider Demographics
NPI:1073870465
Name:GLASS, HILARY-ANNE CARPENTER (MSN, CNM, ARNP)
Entity Type:Individual
Prefix:MRS
First Name:HILARY-ANNE
Middle Name:CARPENTER
Last Name:GLASS
Suffix:
Gender:F
Credentials:MSN, CNM, ARNP
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:TALLMAN AVE NW
Practice Address - Street 2:SUITE 420
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3832
Practice Address - Country:US
Practice Address - Phone:206-781-6080
Practice Address - Fax:206-781-6285
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WAAP60699361367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health