Individual
CARRIE A VIEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1810 E 19TH ST, THE DALLES, OR 97058
(541) 296-7677
(541) 296-7206
Mailing address
PO BOX 1520, 1810 E 19TH ST, THE DALLES, OR 97058-1520
(541) 296-7677
(541) 296-7206
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-712
ID
363A00000X
Physician Assistant
Primary
PA150314
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218103
—
OR
Enumeration date
10/15/2007
Last updated
11/25/2009
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