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Individual

TERRYOL BRANDON NOALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
12518 NE AIRPORT WAY STE 110, PORTLAND, OR 97230-1090
(503) 256-2992
(503) 258-0717
Mailing address
200 MULLINS DR, LEBANON, OR 97355-3983
(541) 220-0139

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO202311
OR
208D00000X
General Practice Physician
20A15368
CA

Other

Enumeration date
11/25/2014
Last updated
04/17/2023
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