Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD185165 | OR |
NPI | 1053750687 |
---|---|
Provider Name | Dr. Brianna Lynne Welch |
First Address | Portland, OR 97266-1269 |
Second Address | Portland, OR 97266-1269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 30/09/2020 |