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General NPI Number Information
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NPI Number | 1093818163
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Entity Type | Individual
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Provider Name | CAROL PELMAS MD
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9427 SW BARNES RD
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City | PORTLAND
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State | OR
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Zip | 97225-6652
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Country | US
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Telephone | 503-203-2040
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Fax |
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Provider Business Mailing Address
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Address Line | 604 CABANA LN
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-3731
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | MD18327
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | MD00024535
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License Number State | WA
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