Individual
CAROL A GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP
Contact information
Practice address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(503) 669-3900
Mailing address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(503) 669-3900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
OR 091006551N1
OR
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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