Individual
CAROLYN L O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
3318 VIRGINA WAY, LONGVIEW, WA 98632
(360) 608-3161
Mailing address
108 SE 124TH AVE, VANCOUVER, WA 98684-6015
(360) 608-3161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00010641
WA
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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