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General NPI Number Information
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NPI Number | 1396171500
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Entity Type | Individual
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Provider Name | CAROLINE JOY ROEDER D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 1213 24TH ST #100
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City | ANACORTES
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State | WA
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Zip | 98221
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Country | US
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Telephone | 360-293-3101
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Fax | 360-588-1041
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Provider Business Mailing Address
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Address Line | 3201 COMMERCIAL AVE STE B
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City | ANACORTES
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State | WA
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Zip | 98221-2761
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Country | US
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Telephone | 360-873-5318
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Fax | 360-371-6243
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP60573566
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OL60386634
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License Number State | WA
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