Individual
DR. LUIS FERNANDO CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
6538 N KERBY AVE, PORTLAND, OR 97217-1939
(503) 283-8351
Mailing address
6538 N KERBY AVE, PORTLAND, OR 97217-1939
(503) 283-8351
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200550017NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0022959
—
OR
01
—
ANP 397
OSBN WORKER'S COMP
OR
Enumeration date
05/27/2005
Last updated
04/02/2025
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