Provider Demographics
NPI:1396177119
Name:LAMB, CARRIE L (PA-C)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:L
Last Name:LAMB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:L
Other - Last Name:CONNERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6802 W RIO GRANDE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7684
Mailing Address - Country:US
Mailing Address - Phone:509-572-2201
Mailing Address - Fax:509-783-8844
Practice Address - Street 1:6802 W RIO GRANDE AVE STE 1
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7684
Practice Address - Country:US
Practice Address - Phone:509-572-2201
Practice Address - Fax:509-783-8844
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60384204363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical