Jessica Graham Carroll, CRNA
Nurse Anesthetist, Certified Registered in Portland, OR. Individual provider (NPI-1).
NPI number1750683058
StatusActive
Last updated in NPPESFeb 11, 2014
Details
- NPI
- 1750683058
- Entity type
- Individual (NPI-1)
- Name
- Jessica Graham Carroll
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 19, 2010
- Last updated
- Feb 11, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 201360007CRNA | OR | Yes |
Other names
- Jessica Marie Graham (Former Name)
Practice location
1015 Nw 22nd AveAnesthesia Dept
Portland, OR 97210-3025
Phone 503-413-7711
Mailing address
1015 Nw 22nd AveAnesthesia Dept
Portland, OR 97210-3025
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