Individual
BRENNAN J EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8041 E BURNSIDE ST, PORTLAND, OR 97215-1548
(503) 252-3304
Mailing address
8041 E BURNSIDE ST, PORTLAND, OR 97215-1548
(503) 252-3304
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/15/2010
Last updated
02/16/2015
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