Individual
BROOK BIRCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8935 SE POWELL BLVD, PORTLAND, OR 97266-1938
(503) 772-4335
(503) 772-4337
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 865-2395
(509) 865-0757
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA169892
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500677321
—
OR
Enumeration date
03/27/2013
Last updated
03/02/2021
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