DR. CLYDE T. CARPENTER (NPI# 1205906294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205906294 |
| Entity Type | Individual |
| Full Name | DR. CLYDE T. CARPENTER |
| Credential | M.D. |
| Practice Address |
3901 Capital Mall Dr Sw Ste A Olympia WA 98502-8654 |
| Mailing Address |
Po Box 368 Olympia WA 98507-0368 |
| Practice Telephone | 3607868990 |
| Practice Fax Number | 3607869010 |
| Mailing Telephone | 3604918439 |
| Mailing Fax Number | 3604916328 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
MD00032013 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8209587 | 05 |
| Street Address |
3901 CAPITAL MALL DR SW STE A |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-8654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639178361 | Daniel Arthur Churches | Physical Therapist | 3901 Capital Mall Dr Sw, Ste D, Olympia, WA 98502-8654 | 2005-07-15 |
| 1265937379 | Nicole Alisha Spencer | Registered Nurse | 3901 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2018-03-29 |
| 1912402397 | Kori Ann Dijos | Orthopaedic Surgery | 3901 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2018-03-27 |
| 1902350606 | Owen Harris | Physician Assistant | 3901 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2016-08-10 |
| 1376994228 | Dana Beth Hooper | Physical Therapist | 3901 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2016-06-22 |
| 1649639709 | Katie Jean Walczyk | Physical Therapist | 3901 Capital Mall Dr Sw, Suite D, Olympia, WA 98502-8654 | 2016-02-17 |
| 1609233527 | Camille Haskins | Physical Therapist | 3901 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2016-01-22 |
| 1023494200 | Renea Rochelle Atwood | Physical Therapy Assistant | 3901 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2015-08-10 |
| 1770975732 | Andrew Cummins | Physical Therapy Assistant | 3901 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2015-02-28 |
| 1629474465 | Stephen Burton | Physical Therapist | 3901 Capital Mall Dr Sw, Olympia, WA 98502-8654 | 2014-11-05 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 98502 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891115085 | Alexander H. Arzeno | Orthopaedic Surgery | 510 8th Ave Ne Ste 200, Issaquah, WA 98029-5436 | 2014-04-26 |
| 1922334804 | Alpine Orthopaedic and Spine A Professional Corporation | Orthopaedic Surgery | 212 E Central Ave Ste 365, Spokane, WA 99208-6291 | 2009-10-27 |
| 1912110933 | Virgil V Becker Jr Jd Md Inc Ps | Orthopaedic Surgery | 125 3rd St Ne Ste 401, Auburn, WA 98002-4035 | 2007-05-07 |
| 1003904434 | Farouq A Al-hamdan | Orthopaedic Surgery | 119 S 14th St, Mount Vernon, WA 98274-4114 | 2006-10-11 |
| 1366549040 | Antoine G. Tohmeh | Orthopaedic Surgery | 605 E Holland Ave Ste 200, Spokane, WA 99218-1246 | 2006-09-17 |
| 1447298021 | Paul Edward Schwaegler | Orthopaedic Surgery | 550 16th Ave Ste 404, Seattle, WA 98122-5636 | 2006-06-03 |
| 1588640361 | Michael A Chang | Orthopaedic Surgery | 1211 N 16th Ave, Yakima, WA 98902-1347 | 2005-12-22 |
| 1144228750 | Alan Burchard Brown | Orthopaedic Surgery | 1427 116th Ave Ne, Bellevue, WA 98004-3807 | 2005-07-08 |
| 1699328278 | Bilal Izzat Qutteineh | Orthopaedic Surgery | 550 17th Ave Ste 500, Seattle, WA 98122-5789 | 2019-07-22 |
| 1063924116 | Proliance Surgeons, Inc., P.s | Orthopaedic Surgery | 801 Broadway Ste 617, Seattle, WA 98122-4319 | 2017-10-30 |
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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.