Healthcare Provider Details

I. General information

NPI: 1649101205
Provider Name (Legal Business Name): CARRIE SKINNER, ND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2348 NW LOVEJOY ST
PORTLAND OR
97210-3022
US

IV. Provider business mailing address

4937 SE BOISE ST
PORTLAND OR
97206-4045
US

V. Phone/Fax

Practice location:
  • Phone: 503-224-7224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: CARRIE SKINNER
Title or Position: PHYSICIAN
Credential: ND
Phone: 907-343-9765