Provider Demographics
NPI:1346463007
Name:CARPENTER, JAMES R (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14820 NE 24TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052
Mailing Address - Country:US
Mailing Address - Phone:425-881-7101
Mailing Address - Fax:425-881-7828
Practice Address - Street 1:14820 NE 24TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052
Practice Address - Country:US
Practice Address - Phone:425-881-7101
Practice Address - Fax:425-881-7828
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034218111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8806681OtherPPIN
V01184Medicare UPIN
WA8806679Medicare PIN