Provider Demographics
NPI:1811704620
Name:CARNEY, AARON
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:CARNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 TOWER AVE
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98577-2020
Mailing Address - Country:US
Mailing Address - Phone:509-930-6233
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 8
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-0008
Practice Address - Country:US
Practice Address - Phone:360-748-3384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASLPI.SI.61588287235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist