Organization
WILLAMETTE UROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYCE CARMAN (ADMINISTRATOR)
(503) 561-7112
Entity
Organization
Contact information
Practice address
591 SE CLAY ST, DALLAS, OR 97338-2812
(503) 561-7100
(503) 561-7124
Mailing address
875 OAK ST SE, SUITE 5030, SALEM, OR 97301-3975
(503) 561-7100
(503) 561-7124
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01954353
OR
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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