Healthcare Provider Details

I. General information

NPI: 1134616022
Provider Name (Legal Business Name): BRMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 LIBERTY ST SE
SALEM OR
97302-4276
US

IV. Provider business mailing address

1395 LIBERTY ST SE
SALEM OR
97302-4276
US

V. Phone/Fax

Practice location:
  • Phone: 503-585-7673
  • Fax: 503-581-3960
Mailing address:
  • Phone: 503-585-7673
  • Fax: 503-581-3960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1411ND
License Number StateOR

VIII. Authorized Official

Name: ELIZABETH R HARMON
Title or Position: PHYSICIAN
Credential: MD
Phone: 503-399-2444