Individual
MRS. DAWN RENAE BROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1535 LIBERTY ST SE, SALEM, OR 97302-4345
(866) 972-0235
Mailing address
2459 SE TUALATIN VALLEY HWY # 416, HILLSBORO, OR 97123-7919
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201805045NP-PP
OR
363LF0000X
Family Nurse Practitioner
4332
MN
Other
Enumeration date
12/28/2015
Last updated
12/20/2022
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