Individual
MRS. CAROL SHYCHY WILLEFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1525 NE WEIDLER ST, SUITE 101, PORTLAND, OR 97232-1410
(503) 525-1143
(503) 287-0212
Mailing address
1525 NE WEIDLER ST, SUITE 101, PORTLAND, OR 97232-1410
(503) 525-1143
(503) 287-0212
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
080044854N6
OR
Other
Enumeration date
07/22/2005
Last updated
07/08/2007
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