Individual
DR. RAYMOND E BRADY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2055 EXCHANGE ST., SUITE 150, ASTORIA, OR 97103
(503) 325-7546
(503) 325-7343
Mailing address
2055 EXCHANGE ST., SUITE 150, ASTORIA, OR 97103
(503) 325-7546
(503) 325-7343
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
MD00017613
WA
207K00000X
Allergy & Immunology Physician
MD10611
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD00017613
WASHINGTON LICENSE
WA
01
—
MD10611
OREGON LICENSE
OR
Enumeration date
03/09/2006
Last updated
05/07/2009
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