Individual provider Active NPI

Brianna Lynne Welch, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
National Provider Identifier
1053750687
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD185165 Issued in OR
Practice address
10340 SE Division St
Portland, OR 97266-1269
Phone
(503) 232-1000
Fax
(877) 575-1360
NPI assigned
Jun 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD185165 OR Primary

Addresses

Primary practice location

10340 SE Division St
Portland, OR 97266-1269

Mailing address

10340 SE Division St
Portland, OR 97266-1269
Phone (503) 232-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180313002319 OR Practitioner - Physical Medicine and Rehabilitation 3375805245 Reassigns benefits to 1 organization
I20191119002126 WA Practitioner - Physical Medicine and Rehabilitation 3375805245 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD185165ORMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Mar 16, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Internal Medicine CurrentSince Feb 20, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Feb 20, 2023 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1053750687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10340 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661269",
            "telephone_number": "503-232-1000",
            "fax_number": "877-575-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10340 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661269",
            "telephone_number": "503-232-1000",
            "fax_number": "877-575-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "BRIANNA",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "MD185165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.