| NPI | 1992432280 |
|---|---|
| Former Name | CARLIE ETTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61570450) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA61570450) |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2026-01-05 |