Individual
JAKOB CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3620 NW SAMARITAN DR STE 202, CORVALLIS, OR 97330-3785
(541) 768-4810
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA223663
OR
Other
Enumeration date
12/16/2024
Last updated
05/02/2025
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