Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 62479 | OR |
NPI | 1649789637 |
---|---|
Provider Name | Dr. Nicole Brun-Cottan |
First Address | Portland, OR 97206-3519 |
Second Address | Vancouver, WA 98660-3493 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2017 |
Last Update Date | 22/09/2017 |