MEDICARE: KATHY Y BRADFORD ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	AP60172219	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12194699	OTHER	WA	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0296462	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1871802769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY Y BRADFORD ARNP

Provider Business Mailing Address
First Line	:	1420 ROOSEVELT AVE STE 4
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-2687
Country	:	US
Telephone Number	:	360-899-4086
Fax Number	:	360-899-4124

Provider Business Practice Location Address
First Line	:	1420 ROOSEVELT AVE STE 4
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-2687
Country	:	US
Telephone Number	:	360-899-4086
Fax Number	:	360-899-4124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2010
Last Update Date	:	05/07/2020

Similar Medicare Providers

1790406718 — ELIZABETH ANNE ELLIS LSWAIC
Practice Location Address:

1420 ROOSEVELT AVE
MOUNT VERNON, WA
98273-2687

Practice Phone: 360-939-1450
Practice Fax:

1841296803 — LORI DELIGHT JOHNSON DC
Practice Location Address:

1420 ROOSEVELT AVE STE 7
MOUNT VERNON, WA
98273-2687

Practice Phone: 360-941-0505
Practice Fax: 360-399-7484

1811944309 — J SEMMES MICKELWAIT MD
Practice Location Address:

1420 ROOSEVELT AVE , SUITE 7
MOUNT VERNON, WA
98273-2687

Practice Phone: 360-424-4186
Practice Fax: 360-428-0927

1114950375 — J SEMMES MICKELWAIT MD PS
Practice Location Address:

1420 ROOSEVELT AVE , SUITE 7
MOUNT VERNON, WA
98273-2687

Practice Phone: 360-424-4186
Practice Fax: 360-428-0927

1457554453 — MISS TAYLOR CHRISTINE FROLING RC
Practice Location Address:

1420 ROOSEVELT AVE STE 2
MOUNT VERNON, WA
98273-2687

Practice Phone: 360-939-1450
Practice Fax:

1568795649 — MICKELWAIT FAMILY DENTISTRY PLLC
Practice Location Address:

1420 ROOSEVELT AVE , STE 7
MOUNT VERNON, WA
98273-2687

Practice Phone: 360-424-3450
Practice Fax: 360-428-0927

Directions to “ KATHY Y BRADFORD ARNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.