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General NPI Number Information
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NPI Number | 1598895013
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Entity Type | Individual
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Provider Name | CORINNE A REKART PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 30 NE MARTIN LUTHER KING JR BLVD
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City | PORTLAND
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State | OR
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Zip | 97232
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Country | US
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Telephone | 503-779-6174
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Fax | 503-232-3854
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Provider Business Mailing Address
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Address Line | 2705 E BURNSIDE ST STE 206
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City | PORTLAND
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State | OR
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Zip | 97214-1768
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Country | US
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Telephone | 971-357-2061
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Fax | 971-357-2561
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61125788
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 201341636RN
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 202010541NP-PP
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License Number State | OR
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