Brazzle, Jessie Edward

Brazzle, Jessie Edward is an individual health care provider with primary practice located at 2415 Se 43Rd Ave Suite 2, Portland OR 97206-1600. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Case Manager/Care Coordinator. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Brazzle, Jessie Edward can be contacted via phone (503) 230-9654.

Contact Information

Primary practice address
2415 Se 43Rd Ave Suite 2 Portland OR 97206-1600
Phone: (503) 230-9654
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CADC 1 Oregon
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1093851412
LBN Legal business name Brazzle, Jessie Edward
Credentials CADC 1
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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