Brigacare, Incorporated

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

BRIGACARE, INCORPORATED

Practice address

20577 SW Duckridge PL
Sherwood, OR 97140-8694

Phone

(503) 840-0387

Fax

(503) 925-3023

NPI assigned

Apr 23, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Robert John Tilley, MD

Title

President

Phone

(503) 840-0387

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1740844984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20577 SW DUCKRIDGE PL",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971408694",
            "telephone_number": "503-840-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20577 SW DUCKRIDGE PL",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971408694",
            "telephone_number": "503-840-0387",
            "fax_number": "503-925-3023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3114 N 30th St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984076360",
            "country_code": "US",
            "telephone_number": "503-840-0387",
            "fax_number": "503-925-3023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRIGACARE, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-23",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "TILLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-840-0387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Sue Blankenbaker, RN
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• Camille Marie Bowen, LMT
• Laurie Branch, QMHA
• Bridgeport Eye Physicians, LLC
• Brigarx, Incorporated
• Julianne Florence Brock, FNP
• Larry David Brock
• Amy Brose Mendenhall, L.AC.
• Michelle Brown

• Developmental Disabilities Clinic/Center in Sherwood, OR
• Providers in Sherwood, OR by specialty
• Developmental Disabilities Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.