Individual
CARLIE BOSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2507 CHRISTIE DRIVE, LAKE OSWEGO, OR 97034
(503) 635-3416
Mailing address
7120 SE LEXINGTON ST, PORTLAND, OR 97206-8766
(512) 965-6596
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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