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Individual

CAROL L NIEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
509 NE ALBERTA ST, PORTLAND, OR 97211-3976
(503) 249-7767
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary

Other

Enumeration date
09/10/2012
Last updated
09/10/2012
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