Healthcare Provider Details

I. General information

NPI: 1013836840
Provider Name (Legal Business Name): BREANNA STEELE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12275 SE 106TH AVE
HAPPY VALLEY OR
97086-7911
US

IV. Provider business mailing address

12275 SE 106TH AVE
HAPPY VALLEY OR
97086-7911
US

V. Phone/Fax

Practice location:
  • Phone: 971-867-0568
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: