Healthcare Provider Details

I. General information

NPI: 1134345242
Provider Name (Legal Business Name): BRADFORD S WEEKS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6456 S CENTRAL AVE
CLINTON WA
98236-0740
US

IV. Provider business mailing address

PO BOX 740 6456 S CENTRAL AVE
CLINTON WA
98236-0740
US

V. Phone/Fax

Practice location:
  • Phone: 360-341-1111
  • Fax:
Mailing address:
  • Phone: 360-341-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD00030856
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD00030856
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: