Provider Demographics
NPI:1942847397
Name:ARNESON, CORINA TUDORACHE
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:TUDORACHE
Last Name:ARNESON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14725 SE RHONE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-2556
Mailing Address - Country:US
Mailing Address - Phone:503-701-5087
Mailing Address - Fax:971-522-1564
Practice Address - Street 1:14725 SE RHONE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-2556
Practice Address - Country:US
Practice Address - Phone:503-701-5087
Practice Address - Fax:971-522-1564
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11291376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide