Healthcare Provider Details

I. General information

NPI: 1699804989
Provider Name (Legal Business Name): CAROLYN J BETLINSKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROLYN J ERWIN RN

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9540 MILL CREEK RD
TILLAMOOK OR
97141-8277
US

IV. Provider business mailing address

9540 MILL CREEK RD
TILLAMOOK OR
97141-8277
US

V. Phone/Fax

Practice location:
  • Phone: 503-842-3263
  • Fax: 503-842-4513
Mailing address:
  • Phone: 503-842-3263
  • Fax: 503-842-4513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: