Active NPI
Braylin Mitchell, LE
- Specialist
- Portland, OR
National Provider Identifier
1124842844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- BAP-E-10249925
- Practice address
- 16239 SE McLoughlin Blvd Ste 208
Portland, OR 97267-4654 - Phone
- (971) 322-5909
- NPI assigned
- Nov 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | BAP-E-10249925 | OR | Primary |
| Specialist | 174400000X | 9964 | CA |
Addresses
Primary practice location
16239 SE McLoughlin Blvd Ste 208
Portland, OR 97267-4654
Mailing address
13424 SE 169TH Ave Apt A112
Happy Valley, OR 97015-8744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9964 | CA | MD | Optometrist |
| BAP-E-10249925 | OR | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glimmer Electrolysis LLC | Specialist | Current | Accepting new patients |
Locations
16239 SE McLoughlin Blvd
Ste 208
Portland, OR 97267
Phone (971) 206-4776
Organizations & group practices 1
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.
-
- Specialist
- Portland, OR
- NPI 1821986639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745884800000",
"number": "1124842844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13424 SE 169TH AVE APT A112",
"city": "HAPPY VALLEY",
"state": "OR",
"postal_code": "970158744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16239 SE MCLOUGHLIN BLVD STE 208",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972674654",
"telephone_number": "971-322-5909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "BRAYLIN",
"credential": "LE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-11-09",
"last_updated": "2025-04-29",
"certification_date": "2025-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "BAP-E-10249925",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "9964",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.