Provider Demographics
NPI:1124552500
Name:BROWDER, PHILIP F (CADC 1)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:F
Last Name:BROWDER
Suffix:
Gender:M
Credentials:CADC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2074 SO. 6TH ST.
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601
Mailing Address - Country:US
Mailing Address - Phone:541-880-2086
Mailing Address - Fax:541-883-3524
Practice Address - Street 1:2074 SO. 6TH ST.
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601
Practice Address - Country:US
Practice Address - Phone:541-851-8110
Practice Address - Fax:541-883-3524
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19-01-14101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1114058898Medicaid