Provider Demographics
NPI:1326810052
Name:SELMANSON, CALINA BROOKE (CD)
Entity Type:Individual
Prefix:
First Name:CALINA
Middle Name:BROOKE
Last Name:SELMANSON
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5126 SE RAINBOW LN
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-4172
Mailing Address - Country:US
Mailing Address - Phone:503-490-4314
Mailing Address - Fax:
Practice Address - Street 1:7800 SW BARBUR BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2895
Practice Address - Country:US
Practice Address - Phone:971-361-6833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty