Provider Demographics
NPI:1467727875
Name:CARTER-PERRY, LUCILE (MED)
Entity Type:Individual
Prefix:
First Name:LUCILE
Middle Name:
Last Name:CARTER-PERRY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 S 140TH ST
Mailing Address - Street 2:#210
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3435
Mailing Address - Country:US
Mailing Address - Phone:206-323-2737
Mailing Address - Fax:206-988-5136
Practice Address - Street 1:149 S 140TH ST
Practice Address - Street 2:#210
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98168-3435
Practice Address - Country:US
Practice Address - Phone:206-323-2737
Practice Address - Fax:206-988-5136
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool