Provider Demographics
NPI:1275701997
Name:BRADY MEDICAL CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:BRADY MEDICAL CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:503-325-7546
Mailing Address - Street 1:2095 EXCHANGE STREET
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3419
Mailing Address - Country:US
Mailing Address - Phone:503-325-7546
Mailing Address - Fax:503-325-7343
Practice Address - Street 1:2095 EXCHANGE STREET
Practice Address - Street 2:SUITE 150
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3419
Practice Address - Country:US
Practice Address - Phone:503-325-7546
Practice Address - Fax:503-325-7343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10611261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty