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Individual

CARLY D BYRNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 276-9677
Mailing address
3939 S BOND AVE APT 619, PORTLAND, OR 97239-4699
(907) 830-8397

Taxonomy

Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
201800002CNS
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
Enumeration date
06/14/2022
Last updated
06/14/2022
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