Individual
DUSTIN DANIEL CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
80 SE MADISON ST STE 150, PORTLAND, OR 97214-4527
(971) 449-7320
Mailing address
80 SE MADISON ST STE 150, PORTLAND, OR 97214-4527
(971) 449-7320
(949) 989-8079
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201702479NP-PP
OR
363LF0000X
Family Nurse Practitioner
340594
NY
Other
Enumeration date
04/22/2016
Last updated
04/07/2026
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