Healthcare Provider Details

I. General information

NPI: 1538311469
Provider Name (Legal Business Name): BRENNA CALLAHAN BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 NW 169TH PL STE 3070
BEAVERTON OR
97006-7368
US

IV. Provider business mailing address

1815 NW 169TH PL STE 3070
BEAVERTON OR
97006-7368
US

V. Phone/Fax

Practice location:
  • Phone: 971-249-2653
  • Fax: 503-747-4373
Mailing address:
  • Phone: 971-249-2653
  • Fax: 503-747-4373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number284513
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: