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Individual

CARLEY PUTNAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3303 SW BOND AVE STE 5, PORTLAND, OR 97239-4501
(503) 494-6687
(503) 494-1717
Mailing address
1650 NW NAITO PKWY STE 185, PORTLAND, OR 97209-2535
(503) 525-7658

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363AS0400X
Surgical Physician Assistant
Primary
PA187398
OR

Other

Enumeration date
10/31/2017
Last updated
09/10/2019
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