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Individual

MS. CAROL JEAN SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
5941 N CENTRAL, PORTLAND, OR 97203
(503) 988-3909
(503) 988-5907
Mailing address
10801 SE MILL CT, PORTLAND, OR 97216-3219
(503) 257-9835

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
000033517N1
OR

Other

Enumeration date
08/30/2006
Last updated
07/08/2007
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