# PACIFIC CREST CHILDRENS URGENT CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brave Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164947701
- **Authorized official:** DR. COREY ADAIR FISH MD (CHIEF MEDICAL OFFICER)
- **Authorized official phone:** (503) 963-7963

## Contact information

- **Practice address:** 6924 NE SANDY BLVD, PORTLAND, OR 97213-5256
- **Practice address phone:** (503) 300-4111
- **Practice address fax:** (503) 954-2112
- **Mailing address:** 6924 NE SANDY BLVD, PORTLAND, OR 97213-5256
- **Mailing address phone:** (503) 300-4111
- **Mailing address fax:** (503) 954-2122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/04/2017
- **Last updated:** 05/30/2023