AMYBRUNERMD LLC; NPI #1780141804

Contact Information

AMYBRUNERMD LLC

1975 NW 167TH PL STE 100
BEAVERTON, OR 97006-4908

Phone: 971-347-3192
Fax: 503-662-6541
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Gynecology	207VG0400X	16	Physician/Obstetrics & Gynecology

Indicates primary specialty

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NPI Profile & details for AMYBRUNERMD LLC

NPI # 1780141804

LBN Legal business name AMYBRUNERMD LLC

Authorized official AMY BRUNER - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/25/2019

Last updated 02/12/2024 - About 2 years ago

Identifiers

Medicaid

1194757708

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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