Provider Demographics
NPI:1396726519
Name:COTTET, CAROLE E (NP)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:E
Last Name:COTTET
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 SW BARNES RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6772
Mailing Address - Country:US
Mailing Address - Phone:503-734-3535
Mailing Address - Fax:503-734-3530
Practice Address - Street 1:9701 SW BARNES RD
Practice Address - Street 2:SUITE 150
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6772
Practice Address - Country:US
Practice Address - Phone:503-734-3535
Practice Address - Fax:503-734-3530
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000026104 RN363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR282061Medicaid
ORS57985Medicare UPIN
OR106573Medicare ID - Type Unspecified