Provider Demographics
NPI:1477593515
Name:HALL, CARRIE (PT, MHS)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:PT, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WESTLAKE AVE N
Mailing Address - Street 2:STE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-7201
Mailing Address - Country:US
Mailing Address - Phone:206-405-1864
Mailing Address - Fax:206-405-4376
Practice Address - Street 1:3221 EASTLAKE AVE E
Practice Address - Street 2:SUITE 110
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-7125
Practice Address - Country:US
Practice Address - Phone:206-405-1864
Practice Address - Fax:206-405-4376
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00005629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist