Provider Demographics
NPI:1952445439
Name:GRIESMEYER, CAROL K (LAC, RN)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:K
Last Name:GRIESMEYER
Suffix:
Gender:F
Credentials:LAC, RN
Other - Prefix:
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Mailing Address - Street 1:7831 SE LAKE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97267-2193
Mailing Address - Country:US
Mailing Address - Phone:503-653-1468
Mailing Address - Fax:503-653-1468
Practice Address - Street 1:7831 SE LAKE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97267-2193
Practice Address - Country:US
Practice Address - Phone:503-653-1468
Practice Address - Fax:503-653-1468
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORAC00831171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist