NPI 1053760611

Brandon Walcott-Ayers, ATC

Practitioner Athletic Trainer Monmouth, OR

Practice location

Address: 345 Monmouth Ave N, Monmouth, OR 97361-1329
Phone: (503) 838-8251
Mailing address: 3755 SE 10th Ave, Portland, OR 97202-3713

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 2000024240 (OR)

Other Specialist/Technologist providers in Oregon →

Registry record

NPI: 1053760611
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Jun 2016
Record last updated: 14 May 2019

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.