Individual
MR. BRADLEY THOMAS NEWHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD., MAIL CODE SJH-2, PORTLAND, OR 97239-3011
(503) 494-7641
(503) 494-8368
Mailing address
3181 SW SAM JACKSON PARK RD., MAIL CODE SJH-2, PORTLAND, OR 97239-3011
(503) 494-4910
(503) 494-8368
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA176419
OR
363AM0700X
Medical Physician Assistant
Primary
PA176419
OR
Other
Enumeration date
12/29/2011
Last updated
01/28/2021
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