Provider Demographics
NPI:1184660334
Name:MCCARTON, CAROLYN JEAN (DC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JEAN
Last Name:MCCARTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 COLUMBIA BLVD
Mailing Address - Street 2:
Mailing Address - City:ST HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051
Mailing Address - Country:US
Mailing Address - Phone:503-397-0480
Mailing Address - Fax:503-397-0790
Practice Address - Street 1:1561 COLUMBIA BLVD
Practice Address - Street 2:
Practice Address - City:ST HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051
Practice Address - Country:US
Practice Address - Phone:503-397-0480
Practice Address - Fax:503-397-0790
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T 6789Medicare UPIN
OR0000 QGDZZMedicare ID - Type Unspecified