Jessie Edward Brazzle Jr, CADC 1 is a
Case Manager/care Coordinator based in Portland, Oregon. Jessie Edward Brazzle Jr is licensed to practice in * (Not Available) (license number ) and his current practice location is
2415 Se 43rd Ave, Suite 2, Portland, Oregon. He can be reached at his office (for appointments etc.) via phone at
(503) 230-9654.
NPI number for Jessie Edward Brazzle Jr is 1093851412 and his current mailing address is 2415 Se 43rd Ave, Suite 2, Portland, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1093851412.
Healthcare Provider's Profile
| Full Name | Jessie Edward Brazzle Jr |
|---|
| Gender | Male |
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| Speciality | Case Manager/care Coordinator |
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| Location | 2415 Se 43rd Ave, Portland, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1093851412
- Provider Enumeration Date: 01/30/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Jessie Edward Brazzle Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093851412 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CADC 1 (Oregon) | Primary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessie Edward Brazzle Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jessie Edward Brazzle Jr, CADC 1
2415 Se 43rd Ave, Suite 2,
Portland, OR 97206-1600
Ph: (503) 230-9654 | Jessie Edward Brazzle Jr, CADC 1
2415 Se 43rd Ave, Suite 2,
Portland, OR 97206-1600
Ph: (503) 230-9654 |
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