Provider Demographics
NPI:1487232385
Name:CARREON HEALTH LLC
Entity Type:Organization
Organization Name:CARREON HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARREON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:971-266-3325
Mailing Address - Street 1:4230 SE KING RD
Mailing Address - Street 2:PMB 235
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-5259
Mailing Address - Country:US
Mailing Address - Phone:971-266-3325
Mailing Address - Fax:503-719-6224
Practice Address - Street 1:1818 NE IRVING ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2238
Practice Address - Country:US
Practice Address - Phone:503-719-4827
Practice Address - Fax:503-719-6224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care