Marshall Brayton

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

201504963RN Issued in OR

Practice address

621 W Madrone St
Roseburg, OR 97470-3090

Phone

(541) 672-2691

NPI assigned

Apr 20, 2011

Last updated

Dec 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Columbiacare Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1982140588
  NPD (past)

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1275824674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254",
            "telephone_number": "541-672-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W MADRONE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703090",
            "telephone_number": "541-672-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAYTON",
        "first_name": "MARSHALL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-20",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201504963RN",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Ashley Brassart, IBCLC
• Michael Jacob Bratland, DMD
• Andrea S. Braun, DDS
• Katherine Weber Braunlich, D.O
• Phillip Robert Braunlich, D.O.
• Chasteen Renee Brazil
• Kimberly Brent
• Kathleen F. Brewer
• Brian E. Hayes, M.D., P.C.
• Matthew Bricka, RRT

• Psychiatric/Mental Health Registered Nurse in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Psychiatric/Mental Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.