Provider Demographics
NPI:1477941193
Name:BROWN-ECHERD, MICHELLE (ND)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BROWN-ECHERD
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11316 SW 62ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-6780
Mailing Address - Country:US
Mailing Address - Phone:503-464-6911
Mailing Address - Fax:
Practice Address - Street 1:10175 SW BARBUR BLVD STE 300 BB
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-9721
Practice Address - Country:US
Practice Address - Phone:503-464-6911
Practice Address - Fax:503-493-7194
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR117-OB176B00000X
OR374J00000X
OR2077175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500685685Medicaid