Individual
JAMES R CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 240, PORTLAND, OR 97213-2991
(503) 215-6480
(503) 215-6469
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16909
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014642
—
OR
Enumeration date
07/03/2006
Last updated
04/12/2012
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