Individual provider · Type 1 NPI
Paul E. Vanbredavriesman, MD
Adult Medicine Physician · Gresham, OR
NPI number
1043453582
Active
Practice location
18000 SE Stark Street
Gresham, OR 97233
Fax (503) 255-4243
Mailing address
16244 NE San Rafael Dr, 18000 SE Stark Street
Portland, OR 97230-5661
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Medicine Physician Primary | 207QA0505X | MD11073 (OR) |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
Other adult medicine physician providers in Gresham
About NPI 1043453582
Paul E. Vanbredavriesman, MD's National Provider Identifier is 1043453582, issued on Apr 14, 2009. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Gresham, OR. The record was last updated on Apr 14, 2009.