Individual
CAROLE L DENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
19250 SW 65TH AVE, SUITE 325, TUALATIN, OR 97062-7452
(503) 692-1242
(503) 691-3615
Mailing address
7650 SW BEVELAND RD, SUITE 200, PORTLAND, OR 97223-8692
(503) 855-1620
(503) 840-3299
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
096006313N3
OR
363LA2200X
Adult Health Nurse Practitioner
Primary
096006313N3
OR
363LW0102X
Women's Health Nurse Practitioner
096006313N7
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277109
—
OR
Enumeration date
11/07/2005
Last updated
10/08/2018
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