Brent David Fare, CCP

Perfusionist · Portland, OR

Individual Active NPI

NPI number 1164049995

Practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone
(503) 494-1548

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NPI record

NPI
1164049995
Entity type
Individual (Type 1)
Enumeration date
June 27, 2020
Last updated
June 27, 2020
Certified
June 27, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Perfusionist Primary 242T00000X 080013 OR

Mailing address

7241 SW 13TH Dr
Portland, OR 97219-2073
Phone
(503) 319-9457

About Brent Fare

Brent David Fare, CCP is a healthcare provider registered in the NPI registry with the primary taxonomy Perfusionist (code 242T00000X). The practice location is 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011. The NPI number 1164049995 was assigned on June 27, 2020 and the record was last updated on June 27, 2020.

Brent Fare lists a license in the registry: #080013 (OR) for Perfusionist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Brent David Fare, CCP?

The NPI number is 1164049995.

What is the phone number of Brent Fare?

The phone number listed for the practice location is (503) 494-1548.

Where is Brent Fare located?

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011.

What is the taxonomy code for Brent Fare?

The primary taxonomy code is 242T00000X – Perfusionist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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