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Individual

TODD BRADLEY PETRIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7916 SE FOSTER RD STE 201, PORTLAND, OR 97206-4289
(503) 374-3730
Mailing address
PO BOX 16756, PORTLAND, OR 97292-0756
(503) 374-3730
(503) 208-2596

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
17-CRM-013
OR

Other

Enumeration date
05/12/2018
Last updated
05/12/2018
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