Provider Demographics
NPI:1487044475
Name:SOLARI, BRENT
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:SOLARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25099
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97298-0099
Mailing Address - Country:US
Mailing Address - Phone:503-914-2100
Mailing Address - Fax:503-914-2210
Practice Address - Street 1:319 4TH AVE APT 5
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:OR
Practice Address - Zip Code:97138-6055
Practice Address - Country:US
Practice Address - Phone:503-914-2100
Practice Address - Fax:503-914-2210
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR01-R-17101YA0400X
WALW61124119101YM0800X
OR2382101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)