Individual
DEREK J BRIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
499 W 4TH AVE, EUGENE, OR 97401
(541) 686-1262
Mailing address
4061 VIRGINIA AVE, SPRINGFIELD, OR 97478-6472
(541) 891-4485
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223354
—
OR
01
—
930753926
KYDC TAX ID #
OR
Enumeration date
08/26/2013
Last updated
07/08/2018
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