Graham, Brent A.

Graham, Brent A. is an individual health care provider with primary practice located at 9841 Nw Ash St , Portland OR 97229-6281. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Graham, Brent A. can be contacted via phone (503) 201-1120.

Contact Information

Primary practice address
9841 Nw Ash St Portland OR 97229-6281
Phone: (503) 201-1120
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD21539 Oregon

Profile Details

NPI number 1528035474
LBN Legal business name Graham, Brent A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Dec 14th, 2023 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1528035474 NPPES
Alaska MEDICAID MD464OR
Alaska Other 050069040
Alaska MEDICAID 136220
Alaska MEDICAID 8239592

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