Healthcare Provider Details

I. General information

NPI: 1629938568
Provider Name (Legal Business Name): CHARLES C FILLIPUCCI-ARNETT RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHARLIE C FILLIPUCCI-ARNETT RN

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 SE CIRCUIT DR STE 270
HILLSBORO OR
97123-1966
US

IV. Provider business mailing address

7305 SE CIRCUIT DR STE 270
HILLSBORO OR
97123-1966
US

V. Phone/Fax

Practice location:
  • Phone: 503-342-9931
  • Fax: 503-207-9463
Mailing address:
  • Phone: 503-342-9931
  • Fax: 503-207-9463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number201909908RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: