Individual
BRADLEY A FOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6416
(208) 367-2742
Mailing address
PO BOX 4268, PORTLAND, OR 97208-4268
(503) 372-2740
(503) 372-2754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
N32421
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA747
ID
Other
Enumeration date
02/27/2009
Last updated
04/07/2011
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