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Individual

DR. RACHAEL MARIE CARRENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
5050 NE HOYT ST STE 240, PORTLAND, OR 97213-2981
(503) 215-6480
Mailing address
5050 NE HOYT ST STE 240, PORTLAND, OR 97213-2981
(503) 215-6480

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO203600
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11019802A
STATE LICENSE
IN
01
DO203600
STATE LICENSE
OR
Enumeration date
04/07/2017
Last updated
10/13/2021
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