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Individual

DR. BENJAMIN GORDON COULAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP

Contact information

Practice address
512 MAIN ST E, MONMOUTH, OR 97361-2369
(503) 838-1182
Mailing address
512 MAIN ST E, MONMOUTH, OR 97361-2369

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201904528NP-PP
OR

Other

Enumeration date
06/17/2019
Last updated
06/17/2019
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