Individual
CAROL ANN ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2800 N VANCOUVER AVE, SUITE 165, PORTLAND, OR 97227-1630
(503) 413-2902
(503) 413-5220
Mailing address
2800 N VANCOUVER AVE, SUITE 165, PORTLAND, OR 97227-1630
(503) 413-2902
(503) 413-5220
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
000028415N2PNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070131
—
OR
Enumeration date
03/31/2006
Last updated
07/08/2007
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