A Brooke Benz

Key facts

NPI

1154526341

Entity type

Organization (NPI type 2)

Primary specialty

Specialist 174400000X

License

MD14378 (OR)

Legal business name

A BROOKE BENZ

Practice address

1960 NW 167TH PL Ste 205
Beaverton, OR 97006-4804

Phone

(503) 629-7500

Fax

(503) 629-7505

NPI assigned

Jun 18, 2007

Organization subpart

No

Authorized official

Name

A Brooke Benz, MD

Title

Owner Physician & Surgeon

Phone

(503) 629-7500

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• BENZ BONE & JOINT CLINIC Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 7, 2014.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1154526341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 NW 167TH PL STE 205",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064804",
            "telephone_number": "503-629-7500",
            "fax_number": "503-629-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 NW 167TH PL STE 205",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064804",
            "telephone_number": "503-629-7500",
            "fax_number": "503-629-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BROOKE BENZ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "BENZ",
        "authorized_official_first_name": "A BROOKE",
        "authorized_official_title_or_position": "OWNER PHYSICIAN & SURGEON",
        "authorized_official_telephone_number": "503-629-7500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD14378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BENZ BONE & JOINT CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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