Individual
KAREN SUE ULLOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2222 NW LOVEJOY ST, SUITE 322, PORTLAND, OR 97210-5101
(503) 229-7224
(503) 229-8175
Mailing address
2222 NW LOVEJOY ST, SUITE 322, PORTLAND, OR 97210-5101
(503) 229-7224
(503) 229-8175
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD16793
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010244
—
OR
Enumeration date
05/16/2006
Last updated
11/18/2011
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