Provider Demographics
NPI:1801787718
Name:CARPENTER, CARLA ROSE
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ROSE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARLIE
Other - Middle Name:
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2360 SW VALLEYVIEW CT
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-7966
Mailing Address - Country:US
Mailing Address - Phone:503-931-3458
Mailing Address - Fax:
Practice Address - Street 1:61690 PETTIGREW RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2422
Practice Address - Country:US
Practice Address - Phone:541-617-0377
Practice Address - Fax:833-776-0563
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker