Provider Demographics
NPI:1215333406
Name:HAYES, CARRIE MARIE (MHS PA-C)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:MARIE
Last Name:HAYES
Suffix:
Gender:F
Credentials:MHS PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6958 SW VARNS STREET
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8281
Mailing Address - Country:US
Mailing Address - Phone:503-683-7730
Mailing Address - Fax:503-914-0927
Practice Address - Street 1:6958 SW VARNS STREET
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8281
Practice Address - Country:US
Practice Address - Phone:503-683-7730
Practice Address - Fax:503-914-0927
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA093892085R0204X
CAPA580622085R0204X, 363A00000X
TX363A00000X
CA58062363A00000X
ORPA208577363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical