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General NPI Number Information
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NPI Number | 1053702654
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Entity Type | Individual
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Provider Name | RADHIKA BRADY PTA
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Gender | Female
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1519 9TH ST
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City | MARYSVILLE
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State | WA
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Zip | 98270-4600
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Country | US
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Telephone | 425-939-2974
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Fax |
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Provider Business Mailing Address
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Address Line | 5014 80TH AVE NE
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City | MARYSVILLE
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State | WA
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Zip | 98270-6864
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | P160269371
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA61590289
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License Number State | WA
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