Individual
CAROLYN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
715 S COWLEY ST STE 228, SPOKANE, WA 99202-1383
(509) 474-6706
(509) 473-6704
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-0001
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
274832
MA
208100000X
Physical Medicine & Rehabilitation Physician
MD61142658
WA
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD61142658
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/06/2015
Last updated
11/24/2025
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