Provider Demographics
NPI:1437246923
Name:LAFFERTY, CARRIE L (PT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 EVANSTON AVE N.
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103
Mailing Address - Country:US
Mailing Address - Phone:206-459-1773
Mailing Address - Fax:206-783-4777
Practice Address - Street 1:3401 EVANSTON AVE N.
Practice Address - Street 2:SUITE A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103
Practice Address - Country:US
Practice Address - Phone:206-459-1773
Practice Address - Fax:206-783-4777
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA7134208100000X
WAWA7134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation