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NPI Code Detail

MEDICARE: BRAUNWYNN FRANKLIN BAA

MEDICARE: BRAUNWYNN FRANKLIN BAA
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
1175T00000XPeer SpecialistOR

General Provider Information

NPI Number : 1538427257
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRAUNWYNN FRANKLIN BAA
Provider Business Mailing Address
First Line : PO BOX 8459
Second Line :
City : PORTLAND
State : OR
Zip : 97207-8459
Country : US
Telephone Number : 503-238-0769
Fax Number :
Provider Business Practice Location Address
First Line : 209 SW 4TH AVE STE 520
Second Line :
City : PORTLAND
State : OR
Zip : 97204-1825
Country : US
Telephone Number : 503-780-7077
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2012
Last Update Date : 10/04/2018

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Directions to “ BRAUNWYNN FRANKLIN BAA” Practice Location

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