Provider Demographics
NPI:1528801487
Name:EDDY, CAROL JEAN (CD (DONA))
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEAN
Last Name:EDDY
Suffix:
Gender:F
Credentials:CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3057 OPDAL RD E
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-8108
Mailing Address - Country:US
Mailing Address - Phone:360-850-8640
Mailing Address - Fax:
Practice Address - Street 1:3057 OPDAL RD E
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-8108
Practice Address - Country:US
Practice Address - Phone:360-850-8640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula