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Individual

CAROL HOLLY ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3396
(503) 367-8936
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3396
(503) 367-8936

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
200240870RN
OR

Other

Enumeration date
09/09/2022
Last updated
09/09/2022
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