Individual
BRENDA J BRISCHETTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10330 SE 32ND AVE STE 205, MILWAUKIE, OR 97222-6594
(503) 513-8950
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-4255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD22406
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288367
—
OR
Enumeration date
05/24/2006
Last updated
01/05/2021
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