Branch, Mitchell S

Branch, Mitchell S is an sole proprietor health care provider with primary practice located at 1817 Ne 6Th Ave , Portland OR 97212-3960. He recently has only one registered license in Ambulatory Health Care Facilities / Community Health, which is considered as his primary health care specialty. Branch, Mitchell S can be contacted via phone (503) 719-7985.

Contact Information

Primary practice address
1817 Ne 6Th Ave Portland OR 97212-3960
Fax: (503) 994-5262
Website:

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Community Health 261QC1500X 22-CRM-1540 Oregon

Profile Details

NPI number 1063128916
LBN Legal business name Branch, Mitchell S
Credentials CRM
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 24th, 2023
Last updated Jan 24th, 2023 - about last year

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 1063128916 NPPES
Oregon MEDICAID 999999

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