Individual
BRETT ANTHONY QUARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2222 NW LOVEJOY ST, SUITE 315, PORTLAND, OR 97210-5101
(503) 226-6321
(503) 227-3422
Mailing address
2222 NW LOVEJOY ST, SUITE 315, PORTLAND, OR 97210-5101
(503) 226-6321
(503) 227-3422
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60416858
WA
363AS0400X
Surgical Physician Assistant
PA164425
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619241551
—
WA
05
—
5006671545
—
OR
Enumeration date
02/23/2012
Last updated
06/09/2017
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