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Individual

DR. PATRICIA JEAN BRAZIL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
506 SW 6TH AVE, SUITE 602, PORTLAND, OR 97204-1533
(503) 222-5563
(503) 222-5564
Mailing address
506 SW 6TH AVE., SUITE 602, PORTLAND, OR 97204-1526
(503) 222-5563
(503) 222-5564

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1257
OR
103T00000X
Psychologist
Primary
1257
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085287
OMAP
OR
Enumeration date
11/14/2006
Last updated
06/06/2008
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