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Individual

DENNIS M. BRUNEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
87520 BAY RD, CHRISTMAS VALLEY, OR 97641-0377
(541) 576-2343
(541) 576-2869
Mailing address
PO BOX 3300, LA PINE, OR 97739-3300
(541) 576-2343
(541) 576-2869

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00217
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
182817
OR
01
970003593
MEDICARE RAILROAD
Enumeration date
12/26/2006
Last updated
10/15/2015
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