Individual
BRIAN DENNEY BECKER BRONCHEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5251 NE GLISAN ST, BLDG A, 2ND FLOOR, PORTLAND, OR 97213-3052
(503) 215-4860
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
050297
CT
2084P0800X
Psychiatry Physician
Primary
MD165987
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500677178
—
OR
Enumeration date
06/30/2009
Last updated
09/24/2020
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