Provider Demographics
NPI:1134274467
Name:CARVALHO, JAMES F (LMP)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:F
Last Name:CARVALHO
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 E MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-1166
Mailing Address - Country:US
Mailing Address - Phone:509-935-9246
Mailing Address - Fax:509-935-9245
Practice Address - Street 1:610 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-1166
Practice Address - Country:US
Practice Address - Phone:509-935-9246
Practice Address - Fax:509-935-9245
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010302225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist