Bradford, Lori A

Bradford, Lori A is an individual health care provider with primary practice located at 1631 Sw Columbia St , Portland OR 97201-6025. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Bradford, Lori A can be contacted via phone (503) 231-2641.

Contact Information

Primary practice address
1631 Sw Columbia St Portland OR 97201-6025
Phone: (503) 231-2641
Fax: (503) 231-1654
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X THW000104020 Oregon
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 20-CRM-092 Oregon

Profile Details

NPI number 1740897933
LBN Legal business name Bradford, Lori A
Credentials CRM/PSS
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2020
Last updated Oct 25th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740897933 NPPES
Oregon MEDICAID 500785339

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