Provider Demographics
NPI:1104072057
Name:BRENNAN, SHARON (FNP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:LEVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2800 SW 257TH AVENUE
Mailing Address - Street 2:COLUMBIA VIEW FAMILY HEALTH CENTER
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060
Mailing Address - Country:US
Mailing Address - Phone:503-667-7711
Mailing Address - Fax:503-669-8328
Practice Address - Street 1:2800 SW 257TH AVENUE
Practice Address - Street 2:COLUMBIA VIEW FAMILY HEALTH CENTER
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060
Practice Address - Country:US
Practice Address - Phone:503-667-7711
Practice Address - Fax:503-669-8328
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00049600363LF0000X
OR201250061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ140140XVAMedicare UPIN