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Individual

BRANDT OWEN QUINN MINTHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRM

Contact information

Practice address
200 SE HAILEY AVE STE 106, PENDLETON, OR 97801-3072
(541) 429-8844
(541) 429-8822
Mailing address
PO BOX 882, PENDLETON, OR 97801-0882
(541) 429-8844
(541) 429-8822

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
22-CRM-1440
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22-CRM-1440
MHACBO
OR
Enumeration date
01/03/2023
Last updated
01/03/2023
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