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Individual

BRADLEY MCNEIL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
342 FAIRVIEW ST, SILVERTON, OR 97381-1917
(503) 873-1500
Mailing address
PO BOX 94645, SEATTLE, WA 98124-6945
(509) 474-6841

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
202009567CRNA-PP
OR
367500000X
Certified Registered Nurse Anesthetist
AP60436137
WA

Other

Enumeration date
01/17/2012
Last updated
07/27/2022
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