Individual
KRISTEN MAY BRADAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
842 E MAIN ST, MEDFORD, OR 97504-7134
(720) 218-7427
Mailing address
842 E MAIN ST, MEDFORD, OR 97504-7134
(720) 218-7427
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA183419
OR
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500734596
—
OR
Enumeration date
05/04/2016
Last updated
03/31/2021
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