Bradley J Fancher, MD
Internal Medicine in Portland, OR. Individual provider (NPI-1).
NPI number1184733859
StatusActive
Last updated in NPPESOct 13, 2014
Details
- NPI
- 1184733859
- Entity type
- Individual (NPI-1)
- Name
- Bradley J Fancher
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 29, 2006
- Last updated
- Oct 13, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | MD12802 | OR | Yes |
Practice location
10200 Sw Eastridge StSuite 205
Portland, OR 97225-5064
Phone 503-280-4555 · Fax 503-280-4559
Mailing address
10200 Sw Eastridge StSuite 205
Portland, OR 97225-5032
Phone 503-280-4555 · Fax 503-280-4559
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