Individual
DAISY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1114 TACOMA AVE NE, RENTON, WA 98056-3539
(206) 305-6492
Mailing address
1114 TACOMA AVE NE, RENTON, WA 98056-3539
(206) 305-6492
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60574553
WA
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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