Individual
DR. CAROLINE LOUISE KING-WIDDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5940 ULALI DR NE, KEIZER, OR 97303-1500
(503) 813-2000
Mailing address
5940 ULALI DR NE, KEIZER, OR 97303-1500
(503) 813-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301087707
MI
207Q00000X
Family Medicine Physician
Primary
MD151091
OR
207Q00000X
Family Medicine Physician
MD60644334
WA
390200000X
Student in an Organized Health Care Education/Training Program
4301087707
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500622839
—
OR
Enumeration date
03/26/2007
Last updated
12/09/2024
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