Individual
BRENT FIVECOAT
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
8935 SE POWELL BLVD, PORTLAND, OR 97266-1938
(503) 772-4335
(503) 772-4337
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
102193
OK
363L00000X
Nurse Practitioner
201806384RN
OR
363L00000X
Nurse Practitioner
Primary
201808083NP-PP
OR
363L00000X
Nurse Practitioner
AP60909960
WA
363L00000X
Nurse Practitioner
RN60908911
WA
363LF0000X
Family Nurse Practitioner
102193
OK
Other
Enumeration date
04/06/2016
Last updated
03/17/2021
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