Individual
MR. KEVIN BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9135 SW BARNES RD STE 663, PORTLAND, OR 97225-6683
(503) 297-1078
Mailing address
9135 SW BARNES RD STE 663, PORTLAND, OR 97225-6683
(971) 244-0798
(503) 542-0162
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-166067
OR
Other
Enumeration date
09/13/2012
Last updated
09/16/2021
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