Broddie, Devery Gerard

Broddie, Devery Gerard is an sole proprietor health care provider with primary practice located at 315 Oak St. Ste 200 , Hood River OR 97031. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Nursing Service Related Providers / Adult Companion, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist is his primary health care specialty. Broddie, Devery Gerard can be contacted via phone (541) 386-0009.

Contact Information

Primary practice address
315 Oak St. Ste 200 Hood River OR 97031
Phone: (541) 386-0009
Fax: (541) 386-0029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Nursing Service Related Providers / Adult Companion 372600000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 7291 Oregon

Profile Details

NPI number 1972649903
LBN Legal business name Broddie, Devery Gerard
Credentials LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 29th, 2007
Last updated Aug 31st, 2020 - about 4 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 1972649903 NPPES
Oregon MEDICAID 1972649903

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