Healthcare Provider Details

I. General information

NPI: 1720173073
Provider Name (Legal Business Name): MERILEE DEBORAH KARR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4855 SW WESTERN AVE
BEAVERTON OR
97005-3460
US

IV. Provider business mailing address

617 SW HUME ST
PORTLAND OR
97219-4458
US

V. Phone/Fax

Practice location:
  • Phone: 503-643-7565
  • Fax:
Mailing address:
  • Phone: 503-245-2185
  • Fax: 503-452-8920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD16049
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: