Provider Demographics
NPI:1164297628
Name:MORGAN, CARRIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 GRIFFIN AVE # 225
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-3418
Mailing Address - Country:US
Mailing Address - Phone:804-387-3061
Mailing Address - Fax:
Practice Address - Street 1:553 ROOSEVELT AVE STE 101
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2990
Practice Address - Country:US
Practice Address - Phone:360-825-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61469775225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist