Individual
KORI LYNNE CARBONARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
1260 NW WATERHOUSE AVE, BEAVERTON, OR 97006-5747
(503) 356-2420
(503) 356-2425
Mailing address
1260 NW WATERHOUSE AVE, BEAVERTON, OR 97006-5747
(503) 356-2420
(503) 356-2425
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
201390954RN
OR
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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