MEDICARE: METROPOLITAN PEDIATRICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	103TC2200X	Clinical Child & Adolescent Psychologist
5	172V00000X	Community Health Worker
6	363AM0700X	Medical Physician Assistant
7	363LF0000X	Family Nurse Practitioner
8	363LP0200X	Pediatric Nurse Practitioner
9	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7098635	OTHER	WA	WASHINGTON DSMS

General Provider Information

NPI Number	:	1235131632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METROPOLITAN PEDIATRICS, LLC

Provider Business Mailing Address
First Line	:	200 SW MARKET ST STE 1650
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97201-5739
Country	:	US
Telephone Number	:	503-466-1668
Fax Number	:	503-439-6194

Provider Business Practice Location Address
First Line	:	1130 NW 22ND AVE STE 320
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-2970
Country	:	US
Telephone Number	:	503-295-2546
Fax Number	:	503-790-1248

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	DR. RESA BRADEEN
Credential	:	MD
Telephone Number	:	503-466-1668

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	06/03/2025

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Directions to “METROPOLITAN PEDIATRICS, LLC ” Practice Location

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