Individual
REBEKAH CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 N PROVIDENCE DR STE 210, NEWBERG, OR 97132-7582
(503) 537-5900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA202131
OR
Other
Enumeration date
05/02/2019
Last updated
04/21/2023
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