Carrillo, Luis Fernando

Carrillo, Luis Fernando is an individual health care provider with primary practice located at 6538 N Kerby Ave , Portland OR 97217-1939. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Carrillo, Luis Fernando can be contacted via phone (503) 283-8351.

Contact Information

Primary practice address
6538 N Kerby Ave Portland OR 97217-1939
Phone: (503) 283-8351
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X Oregon

Profile Details

NPI number 1083617658
LBN Legal business name Carrillo, Luis Fernando
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083617658 NPPES
Oregon MEDICAID 0022959
Oregon Other ANP 397

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