Individual
DR. JACQUELINE MUNCH BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, MAIL CODE OP 31, PORTLAND, OR 97239-3011
(503) 494-8211
Mailing address
3181 SW SAM JACKSON PARK RD, MAIL CODE OP 31, PORTLAND, OR 97239-3011
(702) 245-8898
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD 156556
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD156556
OR
Other
Enumeration date
04/28/2009
Last updated
09/05/2024
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