Carlson, Kenneth Michael
Carlson, Kenneth Michael is an individual health care provider with primary practice located at 1475 Mount Hood Ave , Woodburn OR 97071-9099. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Carlson, Kenneth Michael can be contacted via phone (503) 981-1509.Contact Information
Primary practice address
1475 Mount Hood Ave
Woodburn OR 97071-9099
Phone: (503) 981-1509
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD22868 | Oregon |
Profile Details
| NPI number | 1952332702 |
|---|---|
| LBN Legal business name | Carlson, Kenneth Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | May 8th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952332702 | NPPES |
| Oregon | MEDICAID | 287244 |
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