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JOHN RODGERS BRADDOCK M.D.
NPI 1225176324
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Lake Oswego, OR

Active since February 01, 2007
4000 KRUSE WAY PL, BUILDING 2, SUITE 160, LAKE OSWEGO, OR 97035(503) 635-1960(503) 635-8354 Get Directions Write a Review

NPPES record last updated: November 15, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About John Rodgers Braddock M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN RODGERS BRADDOCK M.D. (NPI 1225176324) is an individual preventive medicine/occupational environmental medicine provider in Lake Oswego, Oregon, licensed in Oregon (MD09593) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1225176324
Entity TypeIndividualMale
Primary Taxonomy2083P0500X
Provider Legal NameJOHN RODGERS BRADDOCKCredential: M.D.
Location Address4000 KRUSE WAY PL, BUILDING 2, SUITE 160Lake Oswego, OR 97035-5545
Mailing Address4000 Kruse Way Pl, Building 2, Suite 160Lake Oswego, OR 97035-5545 · (503) 635-1960 · Fax (503) 635-8354
Phone(503) 635-1960
Fax(503) 635-8354
Sole ProprietorNo
Enumeration DateFebruary 1, 2007
Last NPPES UpdateNovember 15, 2011
✔ NPI 1225176324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPreventive Medicine · Preventive Medicine/Occupational Environmental MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083P0500X
License✔ Licensed in OR · MD09593
Definition

A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

Also ListedEmergency MedicineTaxonomy 207P00000X · License MD09593 (OR)
4000 KRUSE WAY PL, Lake Oswego, OR 97035
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Other Identifiers 1

Medicare UPINC92264OR

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASCASDE OCCUPATIONAL MEDICINE PHYSICIANS INC
Clinic/Center (Physical Therapy)
4000 KRUSE WAY PL, BUILDING 2, SUITE 160
LAKE OSWEGO, OR 97035
Clackamas County (503) 635-1960
DR. KIMBERLY GUTHRIE I
Chiropractor
4000 KRUSE WAY PL, BLDG 2 SUITE 245
LAKE OSWEGO, OR 97035
Clackamas County (503) 675-8747

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Braddock's NPI number?

The NPI number for John Braddock is 1225176324. It was assigned to this individual provider in the NPPES registry on February 1, 2007.

Where is John Braddock located?

John Braddock practices at 4000 Kruse Way Pl Building 2, Suite 160, Lake Oswego, OR 97035. The listed phone number is (503) 635-1960.

What is John Braddock's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Preventive Medicine/Occupational Environmental Medicine, with taxonomy code 2083P0500X.

When was this NPI record last updated?

The NPPES record for John Braddock was last updated on November 15, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.