| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SEBASTIAN BRUNNING | 1205453420 | 2024-02-02 |
Sebastian Lewis Harris Brunning [M] graduated in 2020 and primarily specializes in Physician Assistant.
Sebastian Brunning is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1205453420. Registration indicates Sebastian Brunning is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Medical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Medical, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, )
| PECOS ID | 7214347558 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Sebastian Brunning |
| Practice Office Address | 1435 G ST SPRINGFIELD, OR US |
| Practice Office Telephone | 5417359420 |
| Practice Office Fax | 5417479870 |
| Mailing Address | 1435 G ST SPRINGFIELD, OR 974774113 US |
| Business Telephone | 5417359420 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1 Serenity Ln | Coburg, OR 974089350 | 5416871110 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 363AM0700X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Medical All Other Specialties & Provider Types Physician Assistant Medical Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | PA201741
OR |