Individual
CARRIE ANN MATYAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2555 MARVIN RD NE, PMG SW WA HAWKS PRAIRIE IM, LACEY, WA 98516-3138
(360) 923-4600
(360) 412-2256
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30006999
WA
Other
Enumeration date
04/27/2006
Last updated
06/17/2021
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