Individual
JEREMY CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
680 TYLER ST, EUGENE, OR 97402-4530
(541) 603-0276
Mailing address
97386, 4715 LONG ST, SWEET HOME, OR 97386
(458) 253-0461
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
114579
OR
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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