Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brent David Fare, CCP

Individual provider Perfusionist · NPI 1164049995

Brent David Fare, CCP is a Perfusionist in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2020

Practice location Address checks out

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-1548
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Perfusionist (primary) Taxonomy 242T00000X · Licence 080013 (OR)

Record details

NPI number1164049995
Entity typeIndividual (Type 1)
GenderMale
Credentials CCP
Sole proprietorYes
NPI enumeratedJune 27, 2020
Last updated in NPPESJune 27, 2020
Certification dateJune 27, 2020
Mailing address7241 Sw 13th Dr, Portland, OR 97219-2073

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