Provider Demographics
NPI:1801882725
Name:HUGHES KING, CAROL J (OT)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:HUGHES KING
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 819
Mailing Address - Street 2:
Mailing Address - City:ORTING
Mailing Address - State:WA
Mailing Address - Zip Code:98360-0819
Mailing Address - Country:US
Mailing Address - Phone:360-893-6576
Mailing Address - Fax:800-661-0688
Practice Address - Street 1:710 NW JUNIPER ST
Practice Address - Street 2:SUITE 106
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2717
Practice Address - Country:US
Practice Address - Phone:425-392-2346
Practice Address - Fax:425-392-0185
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000754225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8396590Medicaid
WAKI2971OtherBLUE SHIELD VM
WAUS0864551OtherAETNA SPECIALIST PIN VM
WA3596KIOtherBLUE SHIELD
WA8419830Medicaid
WA8396590Medicare PIN