Olson, Bradley Garrett

Olson, Bradley Garrett is an individual health care provider with primary practice located at 2800 N Vancouver Ave Ste 165, Portland OR 97227-1630. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Olson, Bradley Garrett can be contacted via phone (503) 413-2902.

Contact Information

Primary practice address
2800 N Vancouver Ave Ste 165 Portland OR 97227-1630
Phone: (503) 413-2902
Fax: (503) 413-5220
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD177926 Oregon
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 206363 New York

Profile Details

NPI number 1154365369
LBN Legal business name Olson, Bradley Garrett
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Aug 27th, 2016 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1154365369 NPPES
New York MEDICAID 01757060

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