Provider Demographics
NPI:1275856379
Name:STRONG, CARON LEONA
Entity Type:Individual
Prefix:
First Name:CARON
Middle Name:LEONA
Last Name:STRONG
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 1:750 NW 185TH AVE
Mailing Address - Street 2:UNIT 308
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-2874
Mailing Address - Country:US
Mailing Address - Phone:503-629-7138
Mailing Address - Fax:503-629-7138
Practice Address - Street 1:356 SE 9TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4202
Practice Address - Country:US
Practice Address - Phone:503-681-4366
Practice Address - Fax:503-681-4374
Is Sole Proprietor?:No
Enumeration Date:2010-03-04
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200850144NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily