Brooke Pascoe Dorsett, PTA
Individual provider Active NPI Contractor · Portland, OR
NPI 1982142360 · NPPES record last updated Oct 11, 2023
Key facts
- NPI
- 1982142360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 010914 (OR)
- Practice address
- 6442 NE 38TH Ave
Portland, OR 97211-7812 - Phone
- (415) 235-3078
- NPI assigned
- Feb 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010914 | OR | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 010914 | OR | Yes |
Addresses
Primary practice location
6442 NE 38TH Ave
Portland, OR 97211-7812
Mailing address
6442 NE 38TH Ave
Portland, OR 97211-7812
Phone (415) 235-3078
Other names
- Brooke Pascoe Dorsett
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 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.