Individual
BRIAN D. DENEKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9735 SW SHADY LN, SUITE 201, TIGARD, OR 97223-5481
(503) 620-6625
Mailing address
9735 SW SHADY LN, SUITE 201, TIGARD, OR 97223-5481
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD14428
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180503
WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES
WA
Enumeration date
03/30/2009
Last updated
03/30/2009
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