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NPI Code Detail

MEDICARE: JULIA C BRADLEY M.A.

MEDICARE:   JULIA C BRADLEY  M.A.
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
1101Y00000XCounselorCG60148305WA

General Provider Information

NPI Number : 1154502417
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA C BRADLEY M.A.
Provider Business Mailing Address
First Line : 4504 S 296TH PL
Second Line :
City : AUBURN
State : WA
Zip : 98001-1564
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 610 YAKIMA AVE
Second Line :
City : TACOMA
State : WA
Zip : 98405-4851
Country : US
Telephone Number : 253-396-5244
Fax Number : 253-779-8667
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2007
Last Update Date : 11/28/2018

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Directions to “ JULIA C BRADLEY M.A.” Practice Location

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