Individual
BROOKE PASCOE DORSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6442 NE 38TH AVE, PORTLAND, OR 97211-7812
(415) 235-3078
Mailing address
6442 NE 38TH AVE, PORTLAND, OR 97211-7812
(415) 235-3078
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
010914
OR
Other
Enumeration date
02/06/2017
Last updated
10/11/2023
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