Provider Demographics
NPI:1821827700
Name:CARRIER-BERNDT, MIDORI BERNICE
Entity type:Individual
Prefix:
First Name:MIDORI
Middle Name:BERNICE
Last Name:CARRIER-BERNDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 L ST UNIT A305
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-1469
Mailing Address - Country:US
Mailing Address - Phone:360-286-4483
Mailing Address - Fax:
Practice Address - Street 1:200 PHYSICAL EDUCATION BUILDING BLDG EASTERN
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-2476
Practice Address - Country:US
Practice Address - Phone:509-359-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program