Healthcare Provider Details

I. General information

NPI: 1114366424
Provider Name (Legal Business Name): MATTHEW H BROOKES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 N PROVIDENCE DR STE 210
NEWBERG OR
97132-7523
US

IV. Provider business mailing address

PO BOX 3158
PORTLAND OR
97208-3158
US

V. Phone/Fax

Practice location:
  • Phone: 503-537-5620
  • Fax: 971-282-0099
Mailing address:
  • Phone: 503-215-6494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberDO217571
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: