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Individual

CARRIE IVY BYLOOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
2049 NW HOYT ST, PORTLAND, OR 97209-1260
(503) 321-5127
Mailing address
6118 SE BELMONT ST STE 409, PORTLAND, OR 97215-1983
(503) 367-4097

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
08/29/2019
Last updated
08/29/2019
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