Individual
TATIANA ZUPEKAN BRINCKERHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
777 NW 9TH ST STE 320, CORVALLIS, OR 97330-6169
(541) 768-4900
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
69696
WI
208000000X
Pediatrics Physician
Primary
MD211003
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080735
—
WI
Enumeration date
04/21/2015
Last updated
11/14/2022
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