Individual
DR. CARLY PORAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 RIVERBEND DR, SPRINGFIELD, OR 97477-8800
(541) 681-5124
Mailing address
PO BOX 7247, SPRINGFIELD, OR 97475-0011
(541) 681-5124
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD213832
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2019
Last updated
09/29/2023
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