Individual
KARISSA E CARSTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
MSC 10 5590, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-5551
Mailing address
2478 13TH ST. SE, SALEM, OR 97302-2546
(503) 362-2481
(503) 375-8700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD176951
OR
390200000X
Student in an Organized Health Care Education/Training Program
RS2013-0348
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500707979
—
OR
Enumeration date
03/24/2013
Last updated
09/19/2019
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