Provider Demographics
NPI:1649254061
Name:DEMARCO, CAROLE ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:ANN
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 POINT FOSDICK DR NW
Mailing Address - Street 2:STE 200
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1794
Mailing Address - Country:US
Mailing Address - Phone:206-300-5016
Mailing Address - Fax:
Practice Address - Street 1:4700 POINT FOSDICK DR NW
Practice Address - Street 2:SUITE 302
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-851-3808
Practice Address - Fax:253-851-3188
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002806103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist