Individual
BRADLEY GARRETT OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 N VANCOUVER AVE, STE 165, PORTLAND, OR 97227-1630
(503) 413-2902
(503) 413-5220
Mailing address
2800 N VANCOUVER AVE, STE 165, PORTLAND, OR 97227-1630
(503) 413-2902
(503) 413-5220
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
206363
NY
208000000X
Pediatrics Physician
Primary
MD177926
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01757060
—
NY
Enumeration date
06/16/2006
Last updated
08/27/2016
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