Provider Demographics
NPI:1336783190
Name:BARAFF, BREANNA NICOLE (FNP)
Entity Type:Individual
Prefix:MS
First Name:BREANNA
Middle Name:NICOLE
Last Name:BARAFF
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 SE MAIN ST STE 128
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2462
Mailing Address - Country:US
Mailing Address - Phone:503-261-5950
Mailing Address - Fax:503-261-5998
Practice Address - Street 1:10000 SE MAIN ST STE 128
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2462
Practice Address - Country:US
Practice Address - Phone:503-261-5950
Practice Address - Fax:503-261-5998
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201909194NP-PP363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily