Healthcare Provider Details

I. General information

NPI: 1144259227
Provider Name (Legal Business Name): CARSTEN REINHOLD SEEMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 11/29/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

V. Phone/Fax

Practice location:
  • Phone: 503-418-5700
  • Fax: 503-418-5704
Mailing address:
  • Phone: 503-418-5700
  • Fax: 503-418-5704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD24607
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: