Individual
DR. THERESA G BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
18911 PORTLAND AVE, GLADSTONE, OR 97027-1630
(503) 850-4472
(503) 850-4473
Mailing address
18911 PORTLAND AVE, GLADSTONE, OR 97027-1630
(503) 850-4472
(503) 850-4473
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD13505
OR
208000000X
Pediatrics Physician
MD60266153
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162487
—
OR
Enumeration date
02/06/2006
Last updated
08/11/2015
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