MEDICARE: DR. BRYNDA MARIE QUINN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	4203	OR
2	103TC0700X	Clinical Psychologist	2634	TN

General Provider Information

NPI Number	:	1124188479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYNDA MARIE QUINN PH.D.

Provider Business Mailing Address
First Line	:	4800 N SCOTTSDALE RD STE 2500
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7630
Country	:	US
Telephone Number	:	503-233-5405
Fax Number	:	503-233-2696

Provider Business Practice Location Address
First Line	:	3500 NE M L KING BLVD STE 200
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-2093
Country	:	US
Telephone Number	:	503-327-8205
Fax Number	:	971-254-4882

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2006
Last Update Date	:	02/11/2026

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