Brain Modulation Tillamook

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BRAIN MODULATION TILLAMOOK

Practice address

2003 2ND Street
Tillamook, OR 97141-2303

Phone

(503) 462-1021

Fax

(844) 880-6589

NPI assigned

Nov 19, 2021

Organization subpart

No

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

Authorized official

Name

Donald Olson, MD

Title

Owner

Phone

(503) 969-8822

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1871250274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 BRISTOL PIKE",
            "address_2": "SUITE 2-220",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190205361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 2ND STREET",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971412303",
            "telephone_number": "503-462-1021",
            "fax_number": "844-880-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN MODULATION TILLAMOOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-969-8822",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danell M Boggs
• Rhonda Sue Bolow, CSWA
• Mark Randall Bowman, M.D.
• David Arthur Bradburn, M.D.
• Esther Darlene Bradeen, PCA
• Craig A Brown, M.D.
• Janine L Brown
• Marcelo RM Carocci
• Kevin Stuart Cheiman, RPH
• Daeh M Christensen-Carney

• Psychiatry Physician in Tillamook, OR
• Providers in Tillamook, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.