Healthcare Provider Details

I. General information

NPI: 1750453908
Provider Name (Legal Business Name): CARINA I BRENT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 KAEN RD SUITE 367
OREGON CITY OR
97045-4035
US

IV. Provider business mailing address

2051 KAEN RD SUITE 367
OREGON CITY OR
97045-4035
US

V. Phone/Fax

Practice location:
  • Phone: 503-742-5377
  • Fax: 503-655-8350
Mailing address:
  • Phone: 503-742-5377
  • Fax: 503-655-8350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StatePW

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: