Provider Demographics
NPI:1770585002
Name:SEARLES, CAROLYN A (ARNP)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:A
Last Name:SEARLES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7947 SE 70TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-5215
Mailing Address - Country:US
Mailing Address - Phone:206-236-5244
Mailing Address - Fax:
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:C6-GS
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-625-7373
Practice Address - Fax:206-223-6372
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001712363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9618505Medicaid
WA8875769Medicare PIN
WA9618505Medicaid
WAAB14864Medicare ID - Type Unspecified