NPI 1164049995

Brent David Fare, CCP

Practitioner Perfusionist Portland, OR

Practice location

Address: 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011
Phone: (503) 494-1548
Mailing address: 7241 SW 13th Dr, Portland, OR 97219-2073

Registered specialties

Perfusionist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 242T00000X Licence 080013 (OR)

Other Perfusionist providers in Oregon →

Registry record

NPI: 1164049995
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jun 2020
Record last updated: 27 Jun 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.