Bryan Gene Collard
Individual provider Active NPI Peer Specialist · Brookings, OR
NPI 1558066795 · NPPES record last updated Apr 4, 2023
Key facts
- NPI
- 1558066795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 615 5TH St # 300
Brookings, OR 97415-9199 - Phone
- (877) 408-8941
- NPI assigned
- Apr 4, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
615 5TH St # 300
Brookings, OR 97415-9199
Mailing address
PO Box 1121
Roseburg, OR 97470-0254
Phone (541) 672-2691
Other providers in Brookings, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2023. 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.