Healthcare Provider Details

I. General information

NPI: 1356807275
Provider Name (Legal Business Name): BROOKE LYNN FRANCIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15875 SW 72ND AVE
TIGARD OR
97224-7913
US

IV. Provider business mailing address

4597 SW TRAIL RD
TUALATIN OR
97062-7783
US

V. Phone/Fax

Practice location:
  • Phone: 971-337-0769
  • Fax: 503-926-6602
Mailing address:
  • Phone: 503-290-6914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberDEM-LD-10196963
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: