Individual
BRENDAN THOMAS BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
2236 SE BELMONT ST, PORTLAND, OR 97214-2817
(503) 445-7699
Mailing address
2236 SE BELMONT ST, PORTLAND, OR 97214-2817
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
175T00000X
Peer Specialist
—
OR
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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