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General NPI Number Information
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NPI Number | 1770443780
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Entity Type | Individual
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Provider Name | CARMEN GRACE PEIRANO
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Gender | Female
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 12670 NW BARNES RD STE 200
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City | PORTLAND
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State | OR
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Zip | 97229-9001
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Country | US
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Telephone | 503-213-7222
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Fax |
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Provider Business Mailing Address
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Address Line | 2724 NE ELAINE DR
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City | MCMINNVILLE
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State | OR
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Zip | 97128-2318
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Country | US
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Telephone | 971-237-0810
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | OR
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