Healthcare Provider Details

I. General information

NPI: 1225453699
Provider Name (Legal Business Name): JENNY R BRADY DNP, FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 NE STUCKI AVE STE 400
HILLSBORO OR
97006-6938
US

IV. Provider business mailing address

11740 SW 68TH PKWY STE 200
PORTLAND OR
97223-9058
US

V. Phone/Fax

Practice location:
  • Phone: 971-350-3080
  • Fax: 206-501-4729
Mailing address:
  • Phone: 425-640-7009
  • Fax: 425-640-9600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1416
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN196906
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10040984
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61441844
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP7319
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0113011
License Number StateAZ
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP7319
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: