Individual
MR. DAVID W BROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BC-HIS
Contact information
Practice address
3000 NW STEWART PKWY, ROSEBURG, OR 97471-1655
(541) 673-1785
(541) 345-6315
Mailing address
8800 SE SUNNYSIDE RD., STE. 300-N, CLACKAMAS, OR 97015-5738
(281) 286-2999
(512) 607-4893
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
—
OR
237700000X
Hearing Instrument Specialist
Primary
HAS-P-824882
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212936
—
OR
01
—
2432417000
FEDERAL WORKERS COMP
—
Enumeration date
03/06/2007
Last updated
01/29/2018
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