Nygaard, Carolyn Iacullo
Nygaard, Carolyn Iacullo is an sole proprietor health care provider with primary practice located at 1490 Commercial St Ste 200 , Astoria OR 97103-3800. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Other Service Providers / Naturopath. Other Service Providers / Naturopath is her primary health care specialty. Nygaard, Carolyn Iacullo can be contacted via phone (503) 741-3636.Contact Information
Primary practice address
1490 Commercial St Ste 200
Astoria OR 97103-3800
Phone: (503) 741-3636
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 1717 | Oregon |
| Other Service Providers / Naturopath | 175F00000X | 1717 | Oregon |
Profile Details
| NPI number | 1649500646 |
|---|---|
| LBN Legal business name | Nygaard, Carolyn Iacullo |
| Credentials | N.D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 13th, 2010 |
| Last updated | Jul 6th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649500646 | NPPES |
| Oregon | MEDICAID | 500642404 |
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