Provider Demographics
NPI:1174995732
Name:CARTER, NADINE ESTHER (MED)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:ESTHER
Last Name:CARTER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:NADINE
Other - Middle Name:E
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:12323 21ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6231
Mailing Address - Country:US
Mailing Address - Phone:425-337-2022
Mailing Address - Fax:
Practice Address - Street 1:4526 FEDERAL AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2132
Practice Address - Country:US
Practice Address - Phone:425-349-8359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor