Carolyn D Concia NP Prof Corp
Nurse Practitioner, Gerontology in Portland, OR. Organization (NPI-2).
NPI number1487216669
StatusActive
Last updated in NPPESJul 8, 2019
Details
- NPI
- 1487216669
- Entity type
- Organization (NPI-2)
- Legal business name
- Carolyn D Concia NP Prof Corp
- Organization subpart
- No
- Enumeration date
- Jul 8, 2019
- Last updated
- Jul 8, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | – | – | Yes |
Practice location
2308 Nw Stimpson LnPortland, OR 97229-8562
Phone 971-294-0560
Mailing address
2308 Nw Stimpson LnPortland, OR 97229-8562
Phone 971-294-0560
Authorized official
Carolyn D Concia
Owner
9712940560
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