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Individual

DANIEL KELLY BRINLEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSFA, CST

Contact information

Practice address
1401 N 10TH AVE, STAYTON, OR 97383-1399
(503) 769-2175
Mailing address
3051 GEHLAR RD NW APT 1050, SALEM, OR 97304-4292

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
204179
OR
246ZS0410X
Surgical Technologist
187526
OR

Other

Enumeration date
08/16/2021
Last updated
08/16/2021
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