Individual
BROOKE OTTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 257-2500
Mailing address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN61057277
WA
163WM0705X
Medical-Surgical Registered Nurse
201141939RN
OR
363LF0000X
Family Nurse Practitioner
Primary
202003090NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP61057326
WA
Other
Enumeration date
02/15/2020
Last updated
05/02/2020
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