1326239971 NPI number — MS. CAREEN ANN LANGSLET MS OTL

Table of content: MS. CAREEN ANN LANGSLET MS OTL (NPI 1326239971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326239971 NPI number — MS. CAREEN ANN LANGSLET MS OTL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANGSLET
Provider First Name:
CAREEN
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS OTL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARSHALL
Provider Other First Name:
CAREEN
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1326239971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
0208 SW LANE STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97239-4300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-464-9455
Provider Business Mailing Address Fax Number:
503-257-1583

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11611 NE AINSWORTH CIRCLE
Provider Second Line Business Practice Location Address:
MULTNOMAH EDUCATION SERVICE DISTRICT
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-257-1653
Provider Business Practice Location Address Fax Number:
503-251-1583
Provider Enumeration Date:
08/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  330902 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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