Individual
JASON KEVIN CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-2200
Mailing address
6312 SW CAPITOL HWY, STE 502, PORTLAND, OR 97239-1938
(503) 452-7423
(503) 464-9035
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA150457
OR
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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