Provider Demographics
NPI:1235813395
Name:LAYTON, CAROLE LOUISE (FNTP)
Entity Type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:LOUISE
Last Name:LAYTON
Suffix:
Gender:F
Credentials:FNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 MOORE ST SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-3516
Mailing Address - Country:US
Mailing Address - Phone:360-790-9680
Mailing Address - Fax:
Practice Address - Street 1:2612 YELM HWY SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-4826
Practice Address - Country:US
Practice Address - Phone:360-507-8146
Practice Address - Fax:360-839-2852
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604151699171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8197OtherNUTRITIONAL THERAPY ASSOCIATION