Organization
DR. DALLAS CARR AND ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALLAS ROBERT CARR O.D. (OWNER)
(360) 943-1516
Entity
Organization
Contact information
Practice address
625 BLACK LAKE BLVD SW, SUITE 110, OLYMPIA, WA 98502-5066
(360) 943-1516
Mailing address
625 BLACK LAKE BLVD SW, SUITE 110, OLYMPIA, WA 98502-5066
(360) 943-1516
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
OD00001152
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2027159
—
WA
Enumeration date
01/25/2007
Last updated
07/22/2008
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