Individual
DR. CAROL A SQUYRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16770 SW EDY RD, STE 102, SHERWOOD, OR 97140-9678
(503) 215-9600
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD28002
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279313
—
OR
Enumeration date
09/28/2006
Last updated
12/16/2013
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