Individual
BRENDA PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1727 SW 4TH ST, GRESHAM, OR 97080-6716
(503) 449-3804
Mailing address
1727 SW 4TH ST, GRESHAM, OR 97080-6716
(503) 449-3804
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
LR60450229
WA
227900000X
Registered Respiratory Therapist
Primary
P-000594
OR
2279H0200X
Home Health Registered Respiratory Therapist
LR60450229
WA
2279H0200X
Home Health Registered Respiratory Therapist
P-00594
OR
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
LR60450229
WA
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
P-000594
OR
2279P4000X
Patient Transport Registered Respiratory Therapist
LR60450229
WA
2279P4000X
Patient Transport Registered Respiratory Therapist
P-000594
OR
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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