Provider Demographics
NPI:1700211273
Name:CARR, ROY PAUL
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:PAUL
Last Name:CARR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 NW VIEWMONT DR
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:OR
Mailing Address - Zip Code:97115-9509
Mailing Address - Country:US
Mailing Address - Phone:971-832-4115
Mailing Address - Fax:
Practice Address - Street 1:159 NW VIEWMONT DR
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:OR
Practice Address - Zip Code:97115-9509
Practice Address - Country:US
Practice Address - Phone:971-832-4115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst