MITCH EDMOND BROCK MD NPI 1295847440

NPI Information

  • NPI: 1295847440
  • Provider Name: MITCH EDMOND BROCK, MD
  • Classification: Otolaryngology - 207Y00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 9800 SE SUNNYSIDE RD
    CLACKAMAS, OR
    ZIP 97015
  • Phone: (503) 653-6440

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NPI Details

Mitch Edmond Brock, MD is an otolaryngology in Clackamas, OR. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. Mitch Edmond Brock, MD NPI is 1295847440. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9800 SE SUNNYSIDE RD
CLACKAMAS, OR
ZIP 97015-750
Phone: (503) 653-6440

The NPI 1295847440 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 2/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Y00000XOtolaryngologyMD00034914WASHINGTONNo
2207Y00000XOtolaryngologyMD19303OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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