Basic Information
| Provider Information | |||||||||
| NPI: | 1538397047 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EARL | ||||||||
| FirstName: | CARYN | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCPO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 EASTLAKE AVE E | ||||||||
| Address2: | UW O&P CLINIC | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065984026 | ||||||||
| FaxNumber: | 2028428427 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 EASTLAKE AVE E | ||||||||
| Address2: | UW O&P CLINIC | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065984026 | ||||||||
| FaxNumber: | 2028428427 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2009 | ||||||||
| LastUpdateDate: | 08/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225000000X | CPO002069 | DE | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Orthotic Fitter | 222Z00000X | OI60444179 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Orthotist | 224P00000X | PS60444370 | WA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Prosthetist |
No ID Information.