Healthcare Provider Details

I. General information

NPI: 1699692483
Provider Name (Legal Business Name): BRIANNE MCBRIDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 MAIN ST
KLAMATH FALLS OR
97601-2636
US

IV. Provider business mailing address

PO BOX 62
KLAMATH FALLS OR
97601-0004
US

V. Phone/Fax

Practice location:
  • Phone: 541-591-4384
  • Fax: 541-205-3533
Mailing address:
  • Phone: 541-591-4384
  • Fax: 541-205-3533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: