Individual
BRADLEY H EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24900 SE STARK ST STE 109, GRESHAM, OR 97030-3381
(503) 413-7162
(503) 674-4140
Mailing address
24900 SE STARK ST STE 109, GRESHAM, OR 97030-3381
(503) 413-7162
(503) 674-4140
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD00043084
WA
207RC0000X
Cardiovascular Disease Physician
Primary
MD17468
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029939
—
OR
05
—
8129918
—
WA
Enumeration date
08/11/2005
Last updated
02/20/2024
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