Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 201807431NP-PP | OR |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 634693 | CA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 634693 | CA |
NPI | 1174038491 |
---|---|
Provider Name | Mrs. Luiza Maria Brown |
First Address | Tigard, OR 97224-7584 |
Second Address | Tigard, OR 97224-7584 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2017 |
Last Update Date | 11/01/2022 |