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JEFFREY REED CARLSON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1500 DIVISION ST, 1ST FLOOR, OREGON CITY, OR 97045-1527
(503) 722-3705
Mailing address
PO BOX 3158, ST. CLOUD HOSPITAL, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
44656
MN
2084P0800X
Psychiatry Physician
44656
MN
2084P0800X
Psychiatry Physician
Primary
DO166997
OR
2084P0804X
Child & Adolescent Psychiatry Physician
44656
MN
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
44656
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500672707
OR
05
500684722
OR
Enumeration date
12/21/2005
Last updated
02/20/2017
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