Provider Demographics
NPI:1386820231
Name:BROWN, RICHARD G (SFA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:BROWN
Suffix:
Gender:M
Credentials:SFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3727
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-3727
Mailing Address - Country:US
Mailing Address - Phone:503-922-9700
Mailing Address - Fax:
Practice Address - Street 1:11103 SW DAVIES RD
Practice Address - Street 2:# 1101
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-8302
Practice Address - Country:US
Practice Address - Phone:503-922-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant