Individual
CARRIE COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2613 N RUSSET ST, PORTLAND, OR 97217-6243
(503) 720-3993
Mailing address
8315 N DENVER AVE, PORTLAND, OR 97217-6707
(503) 720-3993
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-57374
VA
Other
Enumeration date
10/28/2014
Last updated
03/05/2015
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