Provider Demographics
NPI:1811201262
Name:BRANDINI, KEVIN CHRISTOPHER (RN)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:CHRISTOPHER
Last Name:BRANDINI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 N KERBY AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-3035
Mailing Address - Country:US
Mailing Address - Phone:503-799-8390
Mailing Address - Fax:
Practice Address - Street 1:4215 N KERBY AVE
Practice Address - Street 2:4805 NE GLISAN ST.
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-3035
Practice Address - Country:US
Practice Address - Phone:503-215-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200840125RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse