Provider Demographics
NPI:1184615775
Name:PLUEDEMAN, CARIN KAY (MD)
Entity type:Individual
Prefix:DR
First Name:CARIN
Middle Name:KAY
Last Name:PLUEDEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 SE ENSIGN LN # B-103
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146-7308
Mailing Address - Country:US
Mailing Address - Phone:035-338-4500
Mailing Address - Fax:503-338-4501
Practice Address - Street 1:1639 SE ENSIGN LN # B-103
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146
Practice Address - Country:US
Practice Address - Phone:035-338-4500
Practice Address - Fax:503-338-4501
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR081575Medicaid
OR116453Medicare ID - Type Unspecified
OR081575Medicaid