CARLA VAN DAM (NPI# 1548773997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548773997 |
| Entity Type | Individual |
| Full Name | CARLA VAN DAM |
| Other Name | CARLA VAN DAM |
| Credential | PHD |
| Practice Address |
2620 Rw Johnson Blvd Sw Suite 204 Tumwater WA 98501 |
| Mailing Address |
Po Box 4453 Tumwater WA 98501-0453 |
| Practice Telephone | 3609560271 |
| Mailing Telephone | 3609560271 |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2018-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY00002218 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LABOR AND INDUSTRIES | 0364237 | 01 |
| Street Address |
2620 RW JOHNSON BLVD SW SUITE 204 |
| City | TUMWATER |
| State | WA |
| Zip Code | 98501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124651880 | Marie T Bendig | Counselor | 900 Fairview St Se, #b5, Olympia, WA 98501 | 2020-02-20 |
| 1205469970 | Thurston County Fire Protection Dist 6 | Ambulance | 8047 Normandy St. Se, Olympia, WA 98501 | 2020-02-20 |
| 1134768799 | Living Sound Therapeutic Services, Pllc | Counselor | 729 Devoe St Se, Olympia, WA 98501 | 2019-12-31 |
| 1336797273 | Sea-mar Community Health Center | Dentist | 6004 Capitol Ave Sw, Tumwater, WA 98501 | 2019-09-03 |
| 1093272841 | Eye Love Pllc | Optometrist | 3409 Capitol Blvd Se, Tumwater, WA 98501 | 2019-02-28 |
| 1356815062 | Kerri Wright | Marriage & Family Therapist | 208 Lee St Sw Ste 108, Tumwater, WA 98501 | 2019-01-15 |
| 1952881161 | Paige Gautreaux | Peer Specialist | 908 5th Avenue Se, Olympia, WA 98501 | 2018-08-16 |
| 1528577202 | Ronald John San Nicolas | Counselor | 1011 10th Ave, Olympia, WA 98501 | 2017-09-25 |
| 1063964187 | Emily Rapesak | Pharmacist | 500 Cleveland Ave Se, Tumwater, WA 98501 | 2016-10-25 |
| 1871960419 | David Lester Rodriguez II | Counselor | 5902 Elm St Se, Tumwater, WA 98501 | 2015-08-31 |
| Find all providers in zip 98501 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447547088 | Loreli Thompson | Psychologist | 7336 Littlerock Rd Sw, Tumwater, WA 98512-7421 | 2011-07-04 |
| 1639347321 | Mukti Khanna | Psychologist | 205 Clark Pl Se, Tumwater, WA 98501-4062 | 2008-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841442 | Jeanette Lee Chong | Psychologist | 2112 3rd Ave N Unit C, Seattle, WA 98109-2304 | 2020-11-04 |
| 1972103026 | River City Tms, Pllc | Psychologist | 400 S Jefferson St Ste 118, Spokane, WA 99204-3142 | 2020-10-28 |
| 1902411366 | Shanna Drinkwine | Psychologist | 1993 Governor Rd, Bellingham, WA 98229-3413 | 2020-09-12 |
| 1760097497 | Laetitia Geoffroy-dallery | Psychologist | 6425 S Cheyenne St, Tacoma, WA 98409-1633 | 2020-09-10 |
| 1487263711 | Tiffany Mohr | Psychologist | 927 College Ln Ne Unit B, Lacey, WA 98516-3740 | 2020-07-22 |
| 1265055172 | Dani Nierenberg Phd Bcb Pllc | Psychologist | 108 Se 124th Ave Ste 12, Vancouver, WA 98684-6015 | 2020-05-27 |
| 1295355923 | Douglas M Wear | Psychologist | 5802 16th Ave Ne, Seattle, WA 98105-2517 | 2020-04-22 |
| 1003435694 | Jared Newman Kilmer | Psychologist | 12025 115th Ave Ne Ste 215, Kirkland, WA 98034-6943 | 2020-04-13 |
| 1447887427 | Kitsap Peninsula Ocd & Anxiety Services Pllc | Psychologist | 9226 Bay Shore Dr Nw Ste 204, Silverdale, WA 98383-9196 | 2020-03-27 |
| 1790311157 | Ryan Mangum | Psychologist | 2009 F St, Vancouver, WA 98663-3345 | 2020-03-18 |
| Find all providers with the same taxonomy | ||||
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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.