| Glenn T. Brasington, Ph.d., Inc. | |
|
429 N Water St Silverton OR 97381-1645 | |
| (503) 310-9157 | |
| (503) 873-6340 |
| Full Name | Glenn T. Brasington, Ph.d., Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 429 N Water St, Silverton, Oregon |
| Authorized Official Name and Position | Glenn Brasingtn (PRESIDENT) |
| Authorized Official Contact | 5033109157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn T. Brasington, Ph.d., Inc. Po Box 962 Silverton OR 97381-0962 Ph: (503) 310-9157 | Glenn T. Brasington, Ph.d., Inc. 429 N Water St Silverton OR 97381-1645 Ph: (503) 310-9157 |
| NPI Number | 1356571194 |
|---|---|
| Provider Enumeration Date | 07/14/2009 |
| Last Update Date | 07/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356571194 | NPI | - | NPPES |
| R000TCHMF | Other | MEDICARE- UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 856 (Oregon) | Primary |
| 103TC1900X | Psychologist - Counseling | 211 (Hawaii) | Secondary |
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