Individual
JESSICA ANN CARLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HAS
Contact information
Practice address
15800 BOONES FERRY RD, SUITE A-1, LAKE OSWEGO, OR 97035-3470
(503) 636-1114
(503) 744-0106
Mailing address
15800 BOONES FERRY RD, SUITE A-1, LAKE OSWEGO, OR 97035-3470
(503) 636-1114
(503) 744-0106
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
HAS-P-10154585
OR
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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