Stephen L Brenneke, M.d., P.c.

NPI #1881868099 in Portland, Oregon

Provider Information

NPI Number: 1881868099
Entity Type: Organization
Organization Name: Stephen L Brenneke, M.d., P.c.
Primary Specialty: Specialist
Enumeration Date: Apr 17, 2008
Last Updated: Apr 17, 2008

Practice Location

Address: 3510 NE 122ND AVE
Address 2: SUITE 103
City: Portland
State: Oregon
ZIP Code: 97230-1500
Phone: (503) 252-0221

Authorized Official

Name: DR. STEPHEN L BRENNEKE, M.D.
Title: PRESIDENT
Phone: (503) 252-0221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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