Individual
BRANDON ROSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
861 W MAIN ST, MOLALLA, OR 97038-9352
(503) 874-5653
Mailing address
PO BOX 3417, PORTLAND, OR 97208-3417
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA182825
OR
Other
Enumeration date
06/28/2017
Last updated
04/09/2026
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