DR. DALLAS CARR AND ASSOCIATES (NPI# 1487700407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487700407 |
| Entity Type | Organization |
| Organization Name | DR. DALLAS CARR AND ASSOCIATES |
| Practice Address |
625 Black Lake Blvd Sw Suite 110 Olympia WA 98502-5066 |
| Practice Telephone | 3609431516 |
| Mailing Telephone | 3609431516 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-07-22 |
| Authorized Official Name | DR. DALLAS ROBERT CARR (OWNER) |
| Authorized Official Telephone | 3609431516 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
OD00001152 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2027159 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | DR. DALLAS CARR AND ASSOCIATES, P.C. | 1780 Barnes Blvd Sw Bldg G, Olympia, WA 98512 |
| Street Address |
625 BLACK LAKE BLVD SW SUITE 110 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-5066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851402085 | Kenneth Douglas Common | Optometrist | 625 Black Lake Blvd Sw, Suite #110, Olympia, WA 98502-5066 | 2006-08-31 |
| 1184004749 | Joseph Beaushaw | Optometrist | 625 Black Lake Blvd Sw, Olympia, WA 98502-5066 | 2015-06-08 |
| 1780987313 | Angela Loeb, Od, Pllc | Optometrist | 625 Black Lake Blvd Sw, Suite 369, Olympia, WA 98502-5066 | 2010-12-21 |
| 1457665739 | Angela Caterina Loeb | Optometrist | 625 Black Lake Blvd Sw, Suite 369, Olympia, WA 98502-5066 | 2010-07-29 |
| 1811052798 | Kenneth D. Common, O.d., P.s. | Clinic/Center | 625 Black Lake Blvd Sw, Suite #110, Olympia, WA 98502-5066 | 2006-12-22 |
| 1073674230 | Jay Woodworth Nelson | Optometrist | 625 Black Lake Blvd Sw, Olympia, WA 98502-5066 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
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| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1144659947 | Edward I Dagher Md Pllc | Clinic/Center | 1822 Black Lake Blvd Sw, Suite 102, Olympia, WA 98512-5628 | 2013-11-02 |
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| 1275888232 | Massage Mundo | Clinic/Center | 423 Eastlake Ave E, Seattle, WA 98109-5408 | 2012-07-16 |
| 1588982060 | Assured Imaging Womens Wellness of Washington, LLC | Clinic/Center | 565 Andover Park W Ste 110, Tukwila, WA 98188-3357 | 2010-05-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.