Close, Bradley Robert

Close, Bradley Robert is an individual health care provider with primary practice located at 900 Sunset Dr , La Grande OR 97850-1387. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Close, Bradley Robert can be contacted via phone (541) 963-8421.

Contact Information

Primary practice address
900 Sunset Dr La Grande OR 97850-1387
Phone: (541) 963-8421
Fax: (541) 963-1476
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 0024173219 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 201902612CRNA Oregon

Profile Details

NPI number 1649638875
LBN Legal business name Close, Bradley Robert
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2016
Last updated Mar 25th, 2022 - about 2 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 1649638875 NPPES
Oregon MEDICAID 500763836

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