Individual
BRENDAN CARGILL CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4805 NE GLISAN ST, UNIT 3K, PORTLAND, OR 97213-2933
(503) 215-6150
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD21047
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130056
—
OR
Enumeration date
07/29/2005
Last updated
02/18/2021
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