Individual
MR. BRADLEY THIREN JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH,CGP,CDM
Contact information
Practice address
4010 AERIAL WAY, EUGENE, OR 97402-9757
(541) 242-8525
(541) 242-8520
Mailing address
1125 LORELLA AVE, EUGENE, OR 97401-7823
(541) 343-7162
(541) 242-8303
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6258
OR
1835P1200X
Pharmacotherapy Pharmacist
HD032131
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0759
GERIATRIC CERTIFICATION
OR
01
—
6258
PHARMACY LISCENSE
OR
01
—
HD032131
DIABETES MANAGMENT CERTIF
OR
Enumeration date
07/07/2005
Last updated
09/11/2025
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