Gaston, Brooks Robert

Gaston, Brooks Robert is an sole proprietor health care provider with primary practice located at 9000 N Lombard St , Portland OR 97203-3006. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Community Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Gaston, Brooks Robert can be contacted via phone (503) 988-5304.

Contact Information

Primary practice address
9000 N Lombard St Portland OR 97203-3006
Phone: (503) 988-5304
Fax: (503) 988-5305
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Community Health 163WC1500X 201150091NP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 201150091NP Oregon

Profile Details

NPI number 1497050801
LBN Legal business name Gaston, Brooks Robert
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 14th, 2011
Last updated Jan 14th, 2013 - about 12 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 1497050801 NPPES
Oregon MEDICAID 22959

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