Healthcare Provider Details

I. General information

NPI: 1669528972
Provider Name (Legal Business Name): KAREN M BROOKS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 PACIFIC BLVD NE
ALBANY OR
97321
US

IV. Provider business mailing address

2730 PACIFIC BLVD NE
ALBANY OR
97321
US

V. Phone/Fax

Practice location:
  • Phone: 541-967-3866
  • Fax: 541-812-8807
Mailing address:
  • Phone: 541-967-3866
  • Fax: 541-812-8807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberL0993
License Number StateTX

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: