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General NPI Number Information
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NPI Number | 1235278482
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Entity Type | Individual
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Provider Name | BROOKE BJORNBERG LOWRY PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 24900 SE STARK ST
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City | GRESHAM
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State | OR
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Zip | 97030-3355
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Country | US
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Telephone | 506-665-1010
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Fax | 503-665-1023
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Provider Business Mailing Address
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Address Line | 24900 SE STARK ST
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City | GRESHAM
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State | OR
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Zip | 97030-3355
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Country | US
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Telephone | 506-665-1010
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Fax | 503-665-1023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA171703
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License Number State | OR
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