Provider Demographics
NPI:1790117265
Name:CARMEL, AMBER NICOLE
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:CARMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17751 NE 90TH ST
Mailing Address - Street 2:APT C316
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6915
Mailing Address - Country:US
Mailing Address - Phone:253-218-9327
Mailing Address - Fax:
Practice Address - Street 1:8351 160TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3854
Practice Address - Country:US
Practice Address - Phone:253-218-9327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60397438225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist