Individual
BREANNE D BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD, STE 100, TIGARD, OR 97224-7258
(503) 216-0700
(503) 216-0750
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO155935
OR
207Q00000X
Family Medicine Physician
LL18349
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500652964
—
OR
01
—
P01287073
RR MEDICARE - PH&S
OR
Enumeration date
06/08/2009
Last updated
02/15/2021
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