Individual
DR. JEANNE LYNNE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10531 SW CAPITOL HWY, PORTLAND, OR 97219-6812
(503) 916-5681
(503) 916-2655
Mailing address
PO BOX 25563, PORTLAND, OR 97298-0563
(503) 916-5681
(503) 916-2655
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
1252
OR
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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