PHILIP BROESAMLE
NPI 1427444264
Counselor - Addiction (Substance Use Disorder) in Shady Cove, OR

Active since April 08, 2015
60 MALLORY LN., SHADY COVE, OR 97539(541) 878-2658 Get Directions Write a Review

NPPES record last updated: April 8, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Philip Broesamle NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHILIP BROESAMLE (NPI 1427444264) is an individual addiction (substance use disorder) provider in Shady Cove, Oregon and active in the NPI registry since April 2015.

NPPES Registry Identity

NPI1427444264
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NamePHILIP BROESAMLE
Location Address60 MALLORY LN.Shady Cove, OR 97539
Mailing AddressPo Box 323Shady Cove, OR 97539
Sole ProprietorYes
Enumeration DateApril 8, 2015
NPI 1427444264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
60 MALLORY LN., Shady Cove, OR 97539

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Philip Broesamle's NPI number?

The NPI number for Philip Broesamle is 1427444264. It was assigned to this individual provider in the NPPES registry on April 8, 2015.

Where is Philip Broesamle located?

Philip Broesamle practices at 60 Mallory Ln., Shady Cove, OR 97539. The listed phone number is (541) 878-2658.

What is Philip Broesamle's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Philip Broesamle was last updated on April 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.