Individual
AUTUMN ELIZABETH BRODIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1302 E 10TH ST, THE DALLES, OR 97058-2932
(503) 320-3021
Mailing address
1302 E 10TH ST, THE DALLES, OR 97058-2932
(503) 320-3021
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
CPT-00039150
CA
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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