Basic Information
| Provider Information | |||||||||
| NPI: | 1457898355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUNKERS | ||||||||
| FirstName: | BRIEENNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7320 SW HUNZIKER ST | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | TIGARD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972238283 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 7320 SW HUNZIKER ST | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | TIGARD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972238283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883171019 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2017 | ||||||||
| LastUpdateDate: | 01/30/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355S0801X | 0A0587 | OR | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
No ID Information.