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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JOHN RODGERS BRADDOCK, M.D.

Active

JOHN RODGERS BRADDOCK, M.D. is a Preventive Medicine healthcare provider located in LAKE OSWEGO, Oregon. NPI 1225176324 is currently active in the NPPES registry. Verify at CMS.

Preventive Medicine · LAKE OSWEGO, OR

Registration Details

NPI Number
1225176324
Provider Type
Individual
Gender
Male
NPI Issued
Feb 1, 2007 (19.541184592933 yrs)
Last Updated
Nov 15, 2011
Licenses
MD09593 (OR)
MD09593 (OR)

Practice Information

Address
4000 KRUSE WAY PL
BUILDING 2, SUITE 160
LAKE OSWEGO, OR, 970355545
Browse OR providers · Browse ZIP 97035
Phone
5036351960
Fax
5036358354
Primary Specialty
Preventive Medicine
2083P0500X
Additional Specialty
Preventive Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.