Federiuk, Carol S
Federiuk, Carol S is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd , Portland OR 97239-3011. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Federiuk, Carol S can be contacted via phone (503) 418-1709.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd
Portland OR 97239-3011
Phone: (503) 418-1709
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | MD16560 | Oregon |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 16560 | Oregon |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207PS0010X | 16560 | Oregon |
Profile Details
| NPI number | 1447209028 |
|---|---|
| LBN Legal business name | Federiuk, Carol S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 9th, 2006 |
| Last updated | Feb 4th, 2017 - about 9 years ago |
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 | 1447209028 | NPPES |
| Oregon | MEDICAID | 287970 |
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