Provider Demographics
NPI:1235378530
Name:KRANABITL, BRIGITTE S (LMT)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:S
Last Name:KRANABITL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0110 SW BANCROFT ST STE E
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4062
Mailing Address - Country:US
Mailing Address - Phone:971-570-9716
Mailing Address - Fax:503-764-9647
Practice Address - Street 1:0110 SW BANCROFT ST STE E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4062
Practice Address - Country:US
Practice Address - Phone:971-570-9716
Practice Address - Fax:503-764-9647
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9306174400000X
OR5706174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist