Individual
JACLYN CARRICATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 CONNECTICUT AVE, NORTH BEND, OR 97459-2300
(631) 291-2498
Mailing address
2000 CONNECTICUT AVE, NORTH BEND, OR 97459-2300
(631) 291-2498
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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