Individual
DR. BRAD C RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2804 19TH AVE, FOREST GROVE, OR 97116-2625
(503) 357-2020
Mailing address
PO BOX 38, FOREST GROVE, OR 97116-0038
(503) 357-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1942AT ACTIVE
OR
237700000X
Hearing Instrument Specialist
HAS-P-470158
OR
Other
Enumeration date
08/02/2005
Last updated
01/11/2012
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