Provider Demographics
NPI:1407350572
Name:CARTER, MICHAEL LEIGH (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEIGH
Last Name:CARTER
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 1:22110 138TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-5430
Mailing Address - Country:US
Mailing Address - Phone:425-283-2504
Mailing Address - Fax:
Practice Address - Street 1:22110 138TH AVE SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-5430
Practice Address - Country:US
Practice Address - Phone:425-283-2504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor