Brockway, David
Brockway, David is an sole proprietor health care provider with primary practice located at 17455 Sw 108Th Pl , Tualatin OR 97062-8427. He recently has only one registered license in Nursing Service Related Providers / Attendant Care Provider, which is considered as his primary health care specialty. Brockway, David can be contacted via phone (503) 298-1935.Contact Information
Primary practice address
17455 Sw 108Th Pl
Tualatin OR 97062-8427
Phone: (503) 298-1935
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Attendant Care Provider | 3747A0650X |
Profile Details
| NPI number | 1154963692 |
|---|---|
| LBN Legal business name | Brockway, David |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 16th, 2019 |
| Last updated | Oct 16th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154963692 | NPPES |
| Oregon | MEDICAID | DZ1386 |
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