Healthcare Provider Details

I. General information

NPI: 1679506992
Provider Name (Legal Business Name): BRADLEY WRIGHT STRONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 MCCALL AVE STE 104
SELMA CA
93662-2560
US

IV. Provider business mailing address

12504 NW 31ST AVE
VANCOUVER WA
98685-2313
US

V. Phone/Fax

Practice location:
  • Phone: 855-343-1057
  • Fax:
Mailing address:
  • Phone: 360-296-4310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG68724
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG68724
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD00039469
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: