Basic Information
Provider Information
NPI: 1649340613
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REMEY
FirstName: CAROL
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 5127
Address2:  
City: EVERETT
State: WA
PostalCode: 982065127
CountryCode: US
TelephoneNumber: 4252583900
FaxNumber:  
Practice Location
Address1: 3927 RUCKER AVE
Address2:  
City: EVERETT
State: WA
PostalCode: 982014833
CountryCode: US
TelephoneNumber: 4253395480
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/08/2006
LastUpdateDate: 05/16/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XAP30006820WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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