Individual
CAROL A SEVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDM,CPM
Contact information
Practice address
1209 SHORTRIDGE ST SE, ALBANY, OR 97322-6934
(541) 928-1002
(541) 327-2721
Mailing address
2532 SANTIAM HWY SE, PMB 314, ALBANY, OR 97322-5211
(541) 928-1002
(541) 327-2721
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LD102953
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140058
—
OR
01
—
98040016
NARM
OR
01
—
LDM-LD 102953
HEALTH LICENSING BOARD
OR
Enumeration date
03/08/2007
Last updated
07/09/2007
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