Individual
CARRIE A BOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4477
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30006047
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9633389
—
WA
Enumeration date
01/31/2007
Last updated
07/09/2007
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