Brittany Samantha Brockman, D.C
Individual provider Active NPI Chiropractor · Wilsonville, OR
NPI 1093445835 · NPPES record last updated Jun 14, 2022
Key facts
- NPI
- 1093445835
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 6219 (OR)
- Practice address
- 30485 SW Boones Ferry Rd Ste 104
Wilsonville, OR 97070-7845 - Phone
- (503) 628-9082
- NPI assigned
- Jun 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6219 | OR | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6219 | OR | Yes |
Addresses
Primary practice location
30485 SW Boones Ferry Rd Ste 104
Wilsonville, OR 97070-7845
Mailing address
30485 SW Boones Ferry Rd Ste 104
Wilsonville, OR 97070-7845
Phone (503) 628-9082
Other providers in Wilsonville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.