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General NPI Number Information
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NPI Number | 1386507291
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Entity Type | Individual
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Provider Name | BRADEN GILBERTSON
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Gender | Male
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 2700 SE STRATUS AVE
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City | MCMINNVILLE
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State | OR
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Zip | 97128-6255
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Country | US
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Telephone | 503-435-6550
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Fax |
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Provider Business Mailing Address
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Address Line | 117 BLUFF LN
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City | DUNDAS
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State | MN
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Zip | 55019-3973
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Country | US
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Telephone | 701-202-4005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 65763
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License Number State | OR
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