Provider Demographics
NPI:1710703467
Name:ARENAS, CAROLYN (LAC, AEMP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:ARENAS
Suffix:
Gender:F
Credentials:LAC, AEMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 N TACOMA AVE APT 1705
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-2725
Mailing Address - Country:US
Mailing Address - Phone:808-333-6183
Mailing Address - Fax:
Practice Address - Street 1:711 ST HELENS AVE STE 103B
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3736
Practice Address - Country:US
Practice Address - Phone:253-780-2006
Practice Address - Fax:253-356-7457
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC61619814171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist