Healthcare Provider Details

I. General information

NPI: 1073682464
Provider Name (Legal Business Name): BRAD JAMES BACHMEIER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E CENTRAL AVE SUITE 245
SPOKANE WA
99208-6291
US

IV. Provider business mailing address

PO BOX 31001-4114
PASADENA CA
91110-4114
US

V. Phone/Fax

Practice location:
  • Phone: 509-252-1977
  • Fax: 509-465-3026
Mailing address:
  • Phone: 866-747-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA60320463
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: