Provider Demographics
NPI:1821063892
Name:KALAHAR, CAROLE S (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:S
Last Name:KALAHAR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:I
Other - Last Name:SKURBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:808 N 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3045
Mailing Address - Country:US
Mailing Address - Phone:360-683-5900
Mailing Address - Fax:360-582-4800
Practice Address - Street 1:808 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3045
Practice Address - Country:US
Practice Address - Phone:360-683-5900
Practice Address - Fax:360-582-4800
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001494363L00000X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7111768Medicaid
WA9601832Medicaid
WA9601832Medicaid
WA7111768Medicaid