Individual
MISS MARILOU N CARRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8216 N BRANDON AVE, PORTLAND, OR 97217-6805
(773) 875-7979
Mailing address
8216 N BRANDON AVE, PORTLAND, OR 97217-6805
(773) 875-7979
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
201040951RN
OR
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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