DR JEN CARROLL LLC NPI 1124792502

NPI Information

NPI: 1124792502
Provider Name: DR JEN CARROLL LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
14535 WESTLAKE DR STE B
LAKE OSWEGO, OR
ZIP 97035
Phone: (971) 353-7990
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DR JEN CARROLL LLC is a health service clinic center in Lake Oswego, OR. DR JEN CARROLL LLC NPI is 1124792502. The provider is registered as an organization entity type.

The provider's business location address is:

14535 WESTLAKE DR STE B
LAKE OSWEGO, OR
ZIP 97035-775
Phone: (971) 353-7990
Fax: (971) 353-7490

The provider's authorized official is Jennifer Renee Carroll .
The authorized official title is Doctor, Owner and has the following contact phone number (971) 353-7990.

The enumeration date for this NPI number is 8/9/2021 and was last updated on 8/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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