Provider Demographics
NPI:1689770521
Name:OGLESBY-JUNK, BROOKS LLEWELLYN (ARNP, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:BROOKS
Middle Name:LLEWELLYN
Last Name:OGLESBY-JUNK
Suffix:
Gender:F
Credentials:ARNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 SW BROADWAY DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-2215
Mailing Address - Country:US
Mailing Address - Phone:971-998-9500
Mailing Address - Fax:
Practice Address - Street 1:5109 NE 82ND AVE STE 215
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6841
Practice Address - Country:US
Practice Address - Phone:877-840-6956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60338248363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health