Organization
STEPHEN L BRENNEKE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN L BRENNEKE M.D. (PRESIDENT)
(503) 252-0221
Entity
Organization
Contact information
Practice address
3510 NE 122ND AVE, SUITE 103, PORTLAND, OR 97230-1500
(503) 252-0221
(503) 253-4769
Mailing address
3510 NE 122ND AVE, SUITE 103, PORTLAND, OR 97230-1500
(503) 252-0221
(503) 253-4769
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD11314
OR
Other
Enumeration date
04/17/2008
Last updated
04/17/2008
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