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General NPI Number Information
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NPI Number | 1093389116
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Entity Type | Individual
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Provider Name | ASHLEY ALISA BRADSHAW RPH
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Gender | Female
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 1115 13TH ST
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City | SNOHOMISH
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State | WA
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Zip | 98290-2012
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Country | US
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Telephone | 360-568-4153
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Fax |
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Provider Business Mailing Address
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Address Line | 6014 183RD ST NW
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City | STANWOOD
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State | WA
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Zip | 98292-6913
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Country | US
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Telephone | 425-622-6294
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 0000000
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH61183666
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License Number State | WA
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