Provider Demographics
NPI:1033933007
Name:FIORILLO, BRENA LYNN (REIKI MASTER)
Entity type:Individual
Prefix:
First Name:BRENA
Middle Name:LYNN
Last Name:FIORILLO
Suffix:
Gender:F
Credentials:REIKI MASTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 N KILPATRICK ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-7244
Mailing Address - Country:US
Mailing Address - Phone:206-914-5546
Mailing Address - Fax:
Practice Address - Street 1:3701 SE MILWAUKIE AVE STE F
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3835
Practice Address - Country:US
Practice Address - Phone:503-841-5323
Practice Address - Fax:503-525-2516
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty