IndividualActive
Brookley Holter, PAC
NPI 1710968375 · Surgical Physician Assistant · Portland, OR
Provider details
- NPI number
- 1710968375
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PAC
- Sex
- Female
- Sole proprietor
- Yes
- License
- PA00818 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3101 Sw Sam Jackson Park Rd
Shriner'S Hospital for Children
Portland, OR 97239
Phone: (503) 221-3428
Fax: (503) 221-3490
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 8500, Lockbox 7642
Philadelphia, PA 19178-7642
Registry dates
- Enumerated
- 2005-11-10
- Last updated
- 2017-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.