Individual
DEENA ANN BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
2555 SILVERTON RD NE STE C, SALEM, OR 97301-0837
(503) 393-4273
Mailing address
1090 8TH ST NW, SALEM, OR 97304-3705
(503) 851-7282
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000003285
OR
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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