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NPI Code Detail

MEDICARE: LEENA CARRIERE D.O.

MEDICARE: LEENA CARRIERE D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianOP60001138WA

General Provider Information

NPI Number : 1982600805
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEENA CARRIERE D.O.
Provider Business Mailing Address
First Line : PO BOX 3360
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3360
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1615 DELAWARE ST
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2367
Country : US
Telephone Number : 360-414-2000
Fax Number : 360-414-7638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 05/21/2021

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Directions to “ LEENA CARRIERE D.O.” Practice Location

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