Bracken, Dawna
Bracken, Dawna is an individual health care provider with primary practice located at 4105 Se International Way Ste 501 , Milwaukie OR 97222-8855. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Bracken, Dawna can be contacted via phone (503) 496-3201.Contact Information
Primary practice address
4105 Se International Way Ste 501
Milwaukie OR 97222-8855
Phone: (503) 496-3201
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | THW000004091 | Oregon |
Profile Details
| NPI number | 1134871155 |
|---|---|
| LBN Legal business name | Bracken, Dawna |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2022 |
| Last updated | Jan 20th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134871155 | NPPES |
| Oregon | MEDICAID | THW000004091 |
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