Individual
BRIANNA L WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(706) 787-4657
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PG220748
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/23/2017
Last updated
07/24/2024
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