Individual
COURTNEY E BROZOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
665 WINTER ST SE, SALEM, OR 97301-3934
(503) 541-2448
Mailing address
1600 STATE ST, SALEM, OR 97301-4257
(503) 540-6300
(503) 540-6404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA180126
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA180126
PA LICENSE
OR
Enumeration date
10/25/2016
Last updated
10/29/2019
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