Provider Demographics
NPI:1427736081
Name:LABAUVE, BRIANNE
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:LABAUVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 923
Mailing Address - Street 2:
Mailing Address - City:PHILOMATH
Mailing Address - State:OR
Mailing Address - Zip Code:97370-0923
Mailing Address - Country:US
Mailing Address - Phone:225-328-1995
Mailing Address - Fax:
Practice Address - Street 1:1750 SW SKYLINE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97221-2545
Practice Address - Country:US
Practice Address - Phone:503-894-9630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health