Individual
CAROLYN M RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
11740 SW 68TH PKWY STE 200, PORTLAND, OR 97223-9058
(503) 308-8340
Mailing address
5441 S MACADAM AVE STE R, PORTLAND, OR 97239-6106
(025) 308-8340
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10045401
OR
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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