Individual provider · Type 1 NPI

Brookley Valentine Holter, PAC

Surgical Physician Assistant · Portland, OR

NPI number 1710968375 Active

Practice location

3101 SW Sam Jackson Park Rd, Shriner's Hospital For Children
Portland, OR 97239

Fax (503) 221-3490

Mailing address

PO Box 8500, Lockbox 7642, Shriner's Hospitals For Children Portland
Philadelphia, PA 19178-7642

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA00818 (OR)

Surgical Physician Assistant: Definition to come...

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About NPI 1710968375

Brookley Valentine Holter, PAC's National Provider Identifier is 1710968375, issued on Nov 10, 2005. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Portland, OR. The record was last updated on Dec 14, 2017.