Individual
ZACHARY CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1601 SW JEFFERSON AVE # 203, CORVALLIS, OR 97331-8656
(541) 974-2421
Mailing address
99086 KEMLIN PL, BROOKINGS, OR 97415-9329
(541) 661-7121
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI-0014537
OR
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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