Organization
LIFE DYNAMICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE MICHELE BROWN RN PMHNP-BC ARNP (LLC SOLE MEMBER)
(541) 771-1548
Entity
Organization
Contact information
Practice address
2100 NE NEFF RD STE B, BEND, OR 97701-6213
(541) 647-2132
(541) 728-0109
Mailing address
2100 NE NEFF RD STE B, BEND, OR 97701-6213
(541) 647-2132
(541) 728-0109
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
2011
OR
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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