Provider Demographics
NPI:1821300112
Name:MURPHY, CARRIE (OD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16006 ASH WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-6352
Mailing Address - Country:US
Mailing Address - Phone:425-787-5200
Mailing Address - Fax:425-787-5252
Practice Address - Street 1:16006 ASH WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-6352
Practice Address - Country:US
Practice Address - Phone:425-787-5200
Practice Address - Fax:425-787-5252
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60348388152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOAAA4292Medicare PIN