IndividualActive
Brent Fare, CCP
NPI 1164049995 · Perfusionist · Portland, OR
Provider details
- NPI number
- 1164049995
- Entity type
- Individual
- Primary specialty
- PerfusionistTechnologists, Technicians & Other Technical Service Providers
- Credential
- CCP
- Sex
- Male
- Sole proprietor
- Yes
- License
- 080013 (OR)
Practice location
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-1548
Mailing address
7241 Sw 13th Dr
Portland, OR 97219-2073
Registry dates
- Enumerated
- 2020-06-27
- Last updated
- 2020-06-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.