Provider Demographics
NPI:1902930464
Name:WILLIAMS, CARI KAY (LMP, NCMMT)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:KAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMP, NCMMT
Other - Prefix:
Other - First Name:CARI
Other - Middle Name:KAY
Other - Last Name:POOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP, NCMMT
Mailing Address - Street 1:11908 E 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-5902
Mailing Address - Country:US
Mailing Address - Phone:425-442-2274
Mailing Address - Fax:509-892-3886
Practice Address - Street 1:524 S UNIVERSITY RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5557
Practice Address - Country:US
Practice Address - Phone:425-442-2274
Practice Address - Fax:509-892-3886
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00009248174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA112303OtherLABOR AND INDUSTRIES #