Individual
MRS. CAROLYN O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1703 S MERIDIAN, STE 101, PUYALLUP, WA 98371-7590
(253) 848-3000
(253) 840-6514
Mailing address
5225 CIRQUE DR W, UNIVERSITY PLACE, WA 98467-3604
(253) 535-3365
(253) 671-7220
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004610
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8436677
—
WA
Enumeration date
05/15/2006
Last updated
12/17/2013
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