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NPI Profile for BROOKLEY V HOLTER in PORTLAND, OR.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1710968375 |
|
| Status | Active | |
| Credentials | PAC | |
| Entity | Individual | |
| Enumeration date | 11/10/2005 | |
| Last updated | 12/14/2017 - About 8 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BROOKLEY V HOLTER
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BROOKLEY V HOLTER, PAC