Active NPI
Carmen Leigh Czachor, D.V.M.
- Veterinarian
- Port Angeles, WA
National Provider Identifier
1336435478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 00004975
- Practice address
- 3217 E Mahogany St
Port Angeles, WA 98362-9072 - Phone
- (360) 452-9682
- NPI assigned
- Jun 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 00004975 | WA | Primary |
Addresses
Primary practice location
3217 E Mahogany St
Port Angeles, WA 98362-9072
Mailing address
3217 Mahogany St
Port Angeles, WA 98362
Phone (360) 452-9682
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00004975 | WA | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309219200000",
"number": "1336435478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3217 MAHOGANY ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "98362",
"telephone_number": "360-452-9682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3217 E MAHOGANY ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983629072",
"telephone_number": "360-452-9682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CZACHOR",
"first_name": "CARMEN",
"middle_name": "LEIGH",
"name_prefix": "Dr.",
"credential": "D.V.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-28",
"last_updated": "2011-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "WA",
"license": "00004975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.