Healthcare Provider Details

I. General information

NPI: 1548193345
Provider Name (Legal Business Name): DANIELLE H BRADSHAW, LICENSED PSYCHOTHERAPIST, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 5TH ST
MUKILTEO WA
98275-1581
US

IV. Provider business mailing address

4711 NORTHPORT DR
MUKILTEO WA
98275-6014
US

V. Phone/Fax

Practice location:
  • Phone: 425-359-6895
  • Fax:
Mailing address:
  • Phone: 425-359-6895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. DANIELLE H BRADSHAW
Title or Position: OWNER
Credential: MHP, LMHC, LCPC
Phone: 425-359-6895