Provider Demographics
NPI:1699804989
Name:BETLINSKI, CAROLYN J (RN)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:J
Last Name:BETLINSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:CAROLYN
Other - Middle Name:J
Other - Last Name:ERWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9540 MILL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141-8277
Mailing Address - Country:US
Mailing Address - Phone:503-842-3263
Mailing Address - Fax:503-842-4513
Practice Address - Street 1:9540 MILL CREEK RD
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-8277
Practice Address - Country:US
Practice Address - Phone:503-842-3263
Practice Address - Fax:503-842-4513
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR098307Medicaid