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NPI Code Detail

MEDICARE: DR. KRISTEN BESSLER BRUSKY D.O.

MEDICARE: DR. KRISTEN BESSLER BRUSKY D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204D00000XNeuromusculoskeletal Medicine & OMM PhysicianDO192463OR
2208100000XPhysical Medicine & Rehabilitation PhysicianDO192463OR

General Provider Information

NPI Number : 1538401724
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTEN BESSLER BRUSKY D.O.
Provider Business Mailing Address
First Line : PO BOX 1189
Second Line :
City : CORVALLIS
State : OR
Zip : 97339-1189
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 675 N 5TH ST
Second Line :
City : LEBANON
State : OR
Zip : 97355-2875
Country : US
Telephone Number : 541-451-6282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2013
Last Update Date : 03/11/2026

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