Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRENT DAVID FARE, CCP
Active Sole ProprietorBRENT DAVID FARE, CCP is a Orthotic Fitter healthcare provider located in PORTLAND, Oregon. NPI 1164049995 is currently active in the NPPES registry. Verify at CMS.
Orthotic Fitter · PORTLAND, OR
Registration Details
- NPI Number
- 1164049995
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 27, 2020 (6.0903518491094 yrs)
- Last Updated
- Jun 27, 2020
- License
-
080013 (OR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3181 SW SAM JACKSON PARK RDPORTLAND, OR, 972393011Browse OR providers · Browse ZIP 97239
- Phone
- 5034941548
- Primary Specialty
-
Orthotic Fitter
242T00000X
Other Orthotic Fitter Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| MRS. JWANA B IBSIES | CCP | 1417574807 |
| JACOB MATTHEW WOJDYLA | CCP | 1598362899 |
| TERAH PARKER | CCP | 1750040879 |
| JORDAN HARTJEN | — | 1447938212 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.