| Brandon Hardaway | |
|
2951 Nw Division St Gresham OR 97030-5292 | |
| (971) 401-3784 | |
| Not Available |
| Full Name | Brandon Hardaway |
|---|---|
| Speciality | Social Worker |
| Location | 2951 Nw Division St, Gresham, Oregon |
| Authorized Official Name and Position | Brandon Hardaway (OWNER) |
| Authorized Official Contact | 9714013784 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandon Hardaway 2951 Nw Division St Gresham OR 97030-5292 | Brandon Hardaway 2951 Nw Division St Gresham OR 97030-5292 Ph: (971) 401-3784 |
| NPI Number | 1336656982 |
|---|---|
| Provider Enumeration Date | 01/04/2018 |
| Last Update Date | 01/04/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336656982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | A4231 (Oregon) | Primary |
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