Healthcare Provider Details

I. General information

NPI: 1497921100
Provider Name (Legal Business Name): BRITT A BENN MS, RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 S BOND AVE
PORTLAND OR
97239-4501
US

IV. Provider business mailing address

1400 SW 5TH AVE
PORTLAND OR
97201-5537
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-6594
  • Fax: 503-494-5385
Mailing address:
  • Phone: 866-617-6855
  • Fax: 503-346-8015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA191220
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number011562
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: