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Individual

CARRIE M EMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
25012 104TH AVE SE, SUITE C, KENT, WA 98030-2821
(253) 856-3477
(253) 856-3478
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007029
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
118314
DEPT OF LABOR & INDUSTRY
WA
01
650015209
RAILROAD MEDICARE
WA
05
8334898
WA
01
8922203
CRIME VICTIMS
WA
01
A002
TRICARE
WA
01
EM5142
REGENCE BLUE SHIELD
WA
Enumeration date
09/27/2006
Last updated
07/03/2015
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