Individual ProviderBryan PeppardCounselorBehavioral Health & Social Service ProvidersPractice Address10714 NE Glisan St, Portland, OR 97220-4046(503) 253-2453PECOS EnrollmentBased on the most recent information from CMS, provider Bryan Peppard does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1790015295Provider TypeIndividualFull NamePeppard, BryanCredentialMAGenderFemaleSole ProprietorNoEnumeration Date1/5/2010Last Updated1/5/2010Contact InformationPractice LocationPractice Address10714 NE Glisan St, Portland, OR 97220-4046Phone(503) 253-2453Fax(503) 254-4271Mailing LocationMailing Address10714 NE Glisan St, Portland, OR 97220-4046Phone(503) 253-2453Fax(503) 254-4271Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer