Laurel Bradford, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD162128 Issued in OR

Practice address

19260 SW 65TH Ave
Suite 340
Tualatin, OR 97062-5701

Phone

(503) 691-9777

NPI assigned

Jun 18, 2010

Last updated

Dec 4, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lbradford90875@direct.lhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Childrens Clinic PC

  • Pediatrics Physician
  • Portland, OR
  • NPI 1649219411
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1902127368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19260 SW 65TH AVE",
            "address_2": "SUITE 340",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970625701",
            "telephone_number": "503-691-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19260 SW 65TH AVE",
            "address_2": "SUITE 340",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970625701",
            "telephone_number": "503-691-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "LAUREL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD162128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig E Bowen, OD
• Angela Bowlby
• Patrick Bowman
• Kimberly Mersch Boyer, MD
• John Dean Boyle, PA
• Anantnoor Kaur Brar, MD
• Ashley Lauren Brauker, ND
• Sarah Breeze, CCC-SLP
• Ryan Brewer, LPN
• Bridgeport MRI LLC (Clearview MRI Tualatin)

• Pediatrics Physician in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.