Braddock, John Rodgers

Braddock, John Rodgers is an individual health care provider with primary practice located at 4000 Kruse Way Pl Building 2, Suite 160, Lake Oswego OR 97035-5545. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine. Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine is his primary health care specialty. Braddock, John Rodgers can be contacted via phone (503) 635-1960.

Contact Information

Primary practice address
4000 Kruse Way Pl Building 2, Suite 160 Lake Oswego OR 97035-5545
Phone: (503) 635-1960
Fax: (503) 635-8354
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD09593 Oregon
Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine 2083P0500X MD09593 Oregon

Profile Details

NPI number 1225176324
LBN Legal business name Braddock, John Rodgers
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2007
Last updated Nov 15th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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