Provider Demographics
NPI:1629417910
Name:CARMEAN, TRACY M (LMP)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:M
Last Name:CARMEAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 156TH ST SW
Mailing Address - Street 2:APT B6
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-6197
Mailing Address - Country:US
Mailing Address - Phone:425-582-2759
Mailing Address - Fax:
Practice Address - Street 1:16303 HIGHWAY 99
Practice Address - Street 2:STE 1B
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-1453
Practice Address - Country:US
Practice Address - Phone:425-743-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60129381225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist