Jacquelyn Dyer Carr

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

414 Front St N
Issaquah, WA 98027-2914

Phone

(425) 392-6367

NPI assigned

Aug 28, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1508479585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W LAKE SAMMAMISH PKWY SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980085938",
            "telephone_number": "713-248-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 FRONT ST N",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272914",
            "telephone_number": "425-392-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "JACQUELYN",
        "middle_name": "DYER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Beth Carlson, RN
• Peter James Carlson, PT
• Susan Therese Carney, PT
• Tana Rae Carpita, MSW
• Dylan Rose Carr, MSW
• Jonathan Carroll, PHARM.D.
• Susan Kay Carroll, RDH
• Amanda Marie Carter, MA60503968
• Scott Cartwright
• Meghan Louise Cary-Neihardt, LMP

• Student in an Organized Health Care Education/Training Program in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.