Individual
JUSTIN WOMOCK BRUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(800) 813-2000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO189652
OR
207Q00000X
Family Medicine Physician
Primary
PG172154
OR
Other
Enumeration date
03/24/2015
Last updated
01/15/2026
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