Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD60512959 | WA |
NPI | 1215990643 |
---|---|
Provider Name | Todd S Carran |
First Address | Portland, OR 97208-3360 |
Second Address | Everett, WA 98201-4147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 03/05/2021 |