Provider Demographics
NPI:1992958318
Name:CARNAHAN, ALLISON DANIELLE (LMP)
Entity type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:DANIELLE
Last Name:CARNAHAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 164TH ST SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5947
Mailing Address - Country:US
Mailing Address - Phone:425-745-2311
Mailing Address - Fax:425-745-2988
Practice Address - Street 1:125 164TH ST SE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-5947
Practice Address - Country:US
Practice Address - Phone:425-745-2311
Practice Address - Fax:425-745-2988
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0220328OtherLABOR AND INDUSTRIES PROVIDER NUMBER