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Organization

GLENN T. BRASINGTON, PH.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLENN BRASINGTN (PRESIDENT)
(503) 310-9157
Entity
Organization

Contact information

Practice address
429 N WATER ST, SILVERTON, OR 97381-1645
(503) 310-9157
(503) 873-6340
Mailing address
PO BOX 962, SILVERTON, OR 97381-0962
(503) 310-9157
(503) 873-6340

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
856
OR
103TC1900X
Counseling Psychologist
211
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R000TCHMF
MEDICARE- UNSPECIFIED
Enumeration date
07/14/2009
Last updated
07/14/2009
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