Individual
BRENT A. MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CES
Contact information
Practice address
2900 NE 132ND AVE, PORTLAND, OR 97230-3014
(503) 847-2546
Mailing address
2900 NE 132ND AVE, PORTLAND, OR 97230-3014
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
9042194-4810
UT
2255A2300X
Athletic Trainer
Primary
AT-AT-10165211
OR
Other
Enumeration date
10/02/2014
Last updated
04/17/2017
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