Individual
MR. JEFF ROBERT CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
11711 NE 12TH ST, SUITE 3A, BELLEVUE, WA 98005-2461
(425) 450-9474
(425) 635-9340
Mailing address
11711 NE 12TH ST, SUITE 3A, BELLEVUE, WA 98005-2461
(425) 450-9474
(425) 635-9340
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005127
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33890
L & I
—
05
—
7851900
—
WA
Enumeration date
07/24/2006
Last updated
08/16/2010
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