Individual
CARRIE EDVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
16120 NE 8TH ST, BELLEVUE, WA 98008-3937
(425) 747-4004
(425) 747-1069
Mailing address
16120 NE 8TH ST, BELLEVUE, WA 98008-3937
(425) 747-4004
(425) 747-1069
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009792
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7018120
—
WA
Enumeration date
01/22/2010
Last updated
01/22/2010
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