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Individual

CODY CARVER FROST-EISENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
1717 S J STREET, TACOMA, WA 98405
(253) 426-4101
Mailing address
1717 S J STREET, TACOMA, WA 98405
(253) 426-4101

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61585860
WA
363AM0700X
Medical Physician Assistant
PA61585860
WA

Other

Enumeration date
03/25/2024
Last updated
08/11/2025
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