Provider Demographics
NPI:1225118961
Name:NEVES, CAREY LOUISE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:LOUISE
Last Name:NEVES
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:CAREY
Other - Middle Name:LOUISE
Other - Last Name:NEVES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:210 SE PIONEER WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-5705
Mailing Address - Country:US
Mailing Address - Phone:360-679-8600
Mailing Address - Fax:360-679-8554
Practice Address - Street 1:210 SE PIONEER WAY STE 2
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-5705
Practice Address - Country:US
Practice Address - Phone:360-679-8600
Practice Address - Fax:360-679-8554
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009610225100000X
OR2012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR230954Medicaid