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Individual
BRAIDON FORREST FREEMAN
Active
Individual
BRAIDON FORREST FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 01014
OR
363A00000X
Physician Assistant
Primary
PA61281463
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500604585
—
OR
Enumeration date
09/27/2005
Last updated
08/01/2022
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