Provider Demographics
NPI:1639631757
Name:COLE, BRIGETTE LYNN (MD)
Entity type:Individual
Prefix:
First Name:BRIGETTE
Middle Name:LYNN
Last Name:COLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-3000
Mailing Address - Fax:503-494-4286
Practice Address - Street 1:180 DAGGETT DR
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4667
Practice Address - Country:US
Practice Address - Phone:413-286-2020
Practice Address - Fax:503-494-4286
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1019526207W00000X, 207WX0009X
ORMD215071207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology