Bradford, Ty David

Bradford, Ty David is an individual health care provider with primary practice located at 863 Liberty St Ne , Salem OR 97301-2451. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Bradford, Ty David can be contacted via phone (877) 522-1275.

Contact Information

Primary practice address
863 Liberty St Ne Salem OR 97301-2451
Phone: (877) 522-1275
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60273 California
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA207912 Oregon

Profile Details

NPI number 1053075077
LBN Legal business name Bradford, Ty David
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2021
Last updated Jan 24th, 2023 - about 2 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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