Healthcare Provider Details

I. General information

NPI: 1215029566
Provider Name (Legal Business Name): LORANEE E BRAUN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER
TACOMA WA
98431
US

IV. Provider business mailing address

995 WILLAGILLESPIE RD
EUGENE OR
97401-2186
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-1823
  • Fax:
Mailing address:
  • Phone: 414-845-4375
  • Fax: 541-343-7360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD186107
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberMD60078135
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberMD186107
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberT8494
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT8494
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: