Individual
DAWNA BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4105 SE INTERNATIONAL WAY STE 501, MILWAUKIE, OR 97222-8855
(503) 496-3201
Mailing address
4105 SE INTERNATIONAL WAY STE 501, MILWAUKIE, OR 97222-8855
(971) 284-3507
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000004091
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THW000004091
—
OR
Enumeration date
01/20/2022
Last updated
01/20/2022
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