Individual
BRADLEY GEORGE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
9169 SW BURNHAM ST, TIGARD, OR 97223-6105
(503) 539-5115
(503) 624-0542
Mailing address
9169 SW BURNHAM ST, TIGARD, OR 97223-6105
(503) 539-5115
(503) 624-0542
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1950ATI
OR
Other
Enumeration date
09/08/2005
Last updated
05/17/2010
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