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NPI Code Detail

MEDICARE: BRADEN GILBERTSON

MEDICARE: BRADEN GILBERTSON
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist65763OR

General Provider Information

NPI Number : 1386507291
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADEN GILBERTSON
Provider Business Mailing Address
First Line : 117 BLUFF LN
Second Line :
City : DUNDAS
State : MN
Zip : 55019-3973
Country : US
Telephone Number : 701-202-4005
Fax Number :
Provider Business Practice Location Address
First Line : 2700 SE STRATUS AVE
Second Line :
City : MCMINNVILLE
State : OR
Zip : 97128-6255
Country : US
Telephone Number : 503-435-6550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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Directions to “ BRADEN GILBERTSON ” Practice Location

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