Individual
DR. CLYDE T. CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3901 CAPITAL MALL DR SW, STE A, OLYMPIA, WA 98502-8654
(360) 786-8990
(360) 786-9010
Mailing address
PO BOX 368, OLYMPIA, WA 98507-0368
(360) 491-8439
(360) 491-6328
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
MD00032013
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8209587
—
WA
Enumeration date
11/08/2006
Last updated
05/23/2016
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