Provider Demographics
NPI:1598972523
Name:BRUBAKER, DONNA S (QMHA)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:S
Last Name:BRUBAKER
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 2ND AVE SW STE 201
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2260
Mailing Address - Country:US
Mailing Address - Phone:541-967-3866
Mailing Address - Fax:
Practice Address - Street 1:425 2ND AVE SW STE 201
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2260
Practice Address - Country:US
Practice Address - Phone:541-967-3866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker