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NPI Code Detail

MEDICARE: CARMEN COSBY CPM, LDM

MEDICARE: CARMEN COSBY CPM, LDM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175M00000XLay MidwifeDEM-LD-10148190OR

General Provider Information

NPI Number : 1073876975
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN COSBY CPM, LDM
Provider Business Mailing Address
First Line : 3323 SW NAITO PKWY
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4672
Country : US
Telephone Number : 503-885-0228
Fax Number : 503-274-0607
Provider Business Practice Location Address
First Line : 3323 SW NAITO PKWY
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4672
Country : US
Telephone Number : 503-885-0228
Fax Number : 503-274-0607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2012
Last Update Date : 06/17/2012

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