Patricia Jean Brazil, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1257 Issued in OR

Practice address

506 SW 6TH Ave
Suite 602
Portland, OR 97204-1533

Phone

(503) 222-5563

Fax

(503) 222-5564

NPI assigned

Nov 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Trish J. Brazil Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1457423527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 SW 6TH AVE.",
            "address_2": "SUITE 602",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041526",
            "telephone_number": "503-222-5563",
            "fax_number": "503-222-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 SW 6TH AVE",
            "address_2": "SUITE 602",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041533",
            "telephone_number": "503-222-5563",
            "fax_number": "503-222-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZIL",
        "first_name": "PATRICIA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "1257",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "085287",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRISH",
            "last_name": "BRAZIL",
            "middle_name": "J.",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Erin Bray, F.N.P.
• Jeffrey Braytenbah
• Brittany Brazell
• Heather Brazelton
• Rita Merle Braziel, MD
• Amiya Juliana-Marie Brazzle-Morgan, RN
• Jessie Edward Brazzle Jr., CADC 1
• Terese Brazzle
• Radhika Sekhri Breaden, MD
• Jason Lee Breaker

• Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.