Provider Demographics
NPI:1376534438
Name:CAROLINE, PATRICK JOSEPH (COT)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:CAROLINE
Suffix:
Gender:M
Credentials:COT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13606 BLAZER TRL
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-1317
Mailing Address - Country:US
Mailing Address - Phone:503-697-9507
Mailing Address - Fax:503-352-2929
Practice Address - Street 1:13606 BLAZER TRL
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-1317
Practice Address - Country:US
Practice Address - Phone:503-697-9507
Practice Address - Fax:503-352-2929
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other