Healthcare Provider Details

I. General information

NPI: 1326806894
Provider Name (Legal Business Name): HOLLY CHRISTINA DORRANCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY CHRISTINA ARCENEAUX

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 SW SAM JACKSON PARK RD
PORTLAND OR
97239-3011
US

IV. Provider business mailing address

1400 SW 5TH AVE STE 500
PORTLAND OR
97201-5537
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-7641
  • Fax: 503-494-4661
Mailing address:
  • Phone:
  • Fax: 503-346-8021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number10002717
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60649543
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN500006221
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: