Brooks, Theresa G

Brooks, Theresa G is an individual health care provider with primary practice located at 18911 Portland Ave , Gladstone OR 97027-1630. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Brooks, Theresa G can be contacted via phone (503) 850-4472.

Contact Information

Primary practice address
18911 Portland Ave Gladstone OR 97027-1630
Phone: (503) 850-4472
Fax: (503) 850-4473
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD13505 Oregon
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD60266153 Washington

Profile Details

NPI number 1578535274
LBN Legal business name Brooks, Theresa G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Aug 11th, 2015 - about 11 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1578535274 NPPES
Oregon MEDICAID 162487

Popular Providers