Individual
ANGELA M CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
2600 NE HIGHWAY 101 STE 200, LINCOLN CITY, OR 97367-4464
(541) 921-3584
(541) 614-1291
Mailing address
2700 SE STRATUS AVE, MCMINNVILLE, OR 97128-6239
(503) 435-4557
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201909732RN
OR
225700000X
Massage Therapist
14899
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10006742
OR
Other
Enumeration date
03/01/2010
Last updated
09/04/2024
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