Provider Demographics
NPI:1912230210
Name:CARBINS, PAUL (LMP)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:CARBINS
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:MADIGAN ARMY MEDICAL CENTER 90390 GARDNER LOOP RD
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-968-9048
Mailing Address - Fax:253-968-9054
Practice Address - Street 1:90390 GARDNER LOOP RD
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1238
Practice Address - Country:US
Practice Address - Phone:253-968-9048
Practice Address - Fax:253-968-9054
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60110628225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist