Individual
THOMAS HIEN BRACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 276-6500
Mailing address
101 SW MAIN ST STE 940, PORTLAND, OR 97204-3216
(503) 464-9034
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
PA217593
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/03/2021
Last updated
01/23/2024
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