Individual
MEGAN DALE THRUSTON BRUSCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4212 NE BROADWAY, PORTLAND, OR 97213-1422
(503) 249-8787
Mailing address
4212 NE BROADWAY, PORTLAND, OR 97213-1422
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD204069
OR
Other
Enumeration date
06/29/2015
Last updated
07/22/2021
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