NPI 1366985483

Braincare, LLC

Organisation Physiological Laboratory Portland, OR

Practice location

Address: 111 SW 5th Ave STE 3150 (unit 3142), Portland, OR 97204-3604
Phone: (866) 848-2522
Fax: (877) 290-1544
Mailing address: 2670 Firewheel Dr STE B, Flower Mound, TX 75028-4601

Authorised official

Name: Janice Shock
Title: Sr Director of Operations
Phone: (214) 532-3757

Registered specialties

Physiological Laboratory Primary

Laboratories Taxonomy 293D00000X

Other Physiological Laboratory providers in Oregon →

Registry record

NPI: 1366985483
Entity type: Organization
NPI issued: 21 Nov 2016
Record last updated: 21 Nov 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.