Organization
AMYBRUNERMD LLC
Active
Organization
AMYBRUNERMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY R BRUNER MD (OWNER)
(503) 804-3861
Entity
Organization
Contact information
Practice address
1975 NW 167TH PL STE 100, BEAVERTON, OR 97006-4908
(971) 347-3192
(503) 662-6541
Mailing address
1975 NW 167TH PL STE 100, BEAVERTON, OR 97006-4908
(971) 347-3192
(503) 662-6541
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194757708
—
OR
Enumeration date
02/25/2019
Last updated
02/12/2024
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