Individual
RICHARD PEYTON CARROLL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
14508 NE 20TH AVE, SUITE 102, VANCOUVER, WA 98686-6424
(360) 574-9730
(360) 576-7662
Mailing address
14508 NE 20TH AVE, SUITE 102, VANCOUVER, WA 98686-6424
(360) 574-9730
(360) 576-7662
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00002292
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8499824
—
WA
Enumeration date
10/20/2005
Last updated
06/26/2008
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