Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A126606 | CA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD177034 | OR |
NPI | 1083974182 |
---|---|
Provider Name | Dr. Emily Hawkins Carter |
First Address | Portland, OR 97239-3098 |
Second Address | Portland, OR 97239-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2012 |
Last Update Date | 02/07/2019 |