Individual
MRS. KRISTIN BRIANA BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
(541) 766-6186
Mailing address
PO BOX 579, CORVALLIS, OR 97339-0579
(541) 766-6835
(541) 766-6186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD150240
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500635248
—
OR
Enumeration date
05/31/2005
Last updated
09/11/2011
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