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General NPI Number Information
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NPI Number | 1295981256
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Entity Type | Individual
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Provider Name | BRIANNE PETRIE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 1815 SW MARLOW AVE STE 218
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City | PORTLAND
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State | OR
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Zip | 97225-5187
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Country | US
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Telephone | 503-444-4862
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Fax | 503-444-4866
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Provider Business Mailing Address
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Address Line | 1500 NW BETHANY BLVD STE 320
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City | BEAVERTON
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State | OR
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Zip | 97006-5238
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Country | US
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Telephone | 503-567-3260
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Fax | 503-567-3264
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2372
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License Number State | OR
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