Healthcare Provider Details

I. General information

NPI: 1841133816
Provider Name (Legal Business Name): NEVAEH BROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1354 BAIR RD NE
KEIZER OR
97303-3343
US

IV. Provider business mailing address

1354 BAIR RD NE
KEIZER OR
97303-3343
US

V. Phone/Fax

Practice location:
  • Phone: 503-509-7857
  • Fax:
Mailing address:
  • Phone: 503-509-7857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: