Provider Demographics
NPI:1689184392
Name:CARTER, MISSY GRIFFITH (PA-C)
Entity Type:Individual
Prefix:
First Name:MISSY
Middle Name:GRIFFITH
Last Name:CARTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:G
Other - Last Name:HUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5123 N 39TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-3623
Mailing Address - Country:US
Mailing Address - Phone:206-300-0828
Mailing Address - Fax:
Practice Address - Street 1:4311 11TH AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-6367
Practice Address - Country:US
Practice Address - Phone:206-616-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-08
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60796670207P00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine