Individual
GLEN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 NW MYHRE RD, SILVERDALE, WA 98383-7663
(564) 240-1000
Mailing address
PO BOX 920135, DALLAS, TX 75392-0135
(877) 346-2211
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00034699
WA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD00034699
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000095
—
WA
05
—
8227183
—
WA
05
—
8460370
—
WA
Enumeration date
07/12/2006
Last updated
03/30/2026
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