Individual
MR. LEWIS S BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1360 JODI DR, SILVERTON, OR 97381-8734
(949) 351-1816
Mailing address
1360 JODI DR, SILVERTON, OR 97381-8734
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA215141
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/17/2020
Last updated
06/29/2023
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