Individual
TIFFANY CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 BLANKENSHIP RD, SUITE 295, WEST LINN, OR 97068-5101
(503) 344-4378
Mailing address
PO BOX 1862, OREGON CITY, OR 97045-0042
(503) 313-3373
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
T59079
OR
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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