Provider Demographics
NPI:1588036909
Name:HALL, CARRIE SUE (ARNP, FNP-C, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:SUE
Last Name:HALL
Suffix:
Gender:F
Credentials:ARNP, FNP-C, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9128 143RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3467
Mailing Address - Country:US
Mailing Address - Phone:425-241-2888
Mailing Address - Fax:
Practice Address - Street 1:723 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5223
Practice Address - Country:US
Practice Address - Phone:206-461-4880
Practice Address - Fax:206-461-6989
Is Sole Proprietor?:No
Enumeration Date:2015-10-25
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAL68365163WL0100X
WAAP61579680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant