Individual
CARL NORTHRUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
864 JARED RD, USK, WA 99180-8703
(509) 671-3949
Mailing address
864 JARED RD, USK, WA 99180-8703
(509) 671-3949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA60354553
WA
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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