Individual
BRYAN SCOTT CHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
890 OAK ST SE, SALEM, OR 97301-3905
(509) 987-6774
Mailing address
22762 SW 106TH AVE, TUALATIN, OR 97062-7385
(509) 987-6774
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD184925
OR
208000000X
Pediatrics Physician
MD60279400
WA
208M00000X
Hospitalist Physician
MD60279400
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025904
KRMC L&I GROUP NUMBER
WA
05
—
1245472430
—
WA
Enumeration date
04/02/2009
Last updated
07/21/2022
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