Bradford, Kathy Y

Bradford, Kathy Y is an individual health care provider with primary practice located at 1420 Roosevelt Ave Ste 4 , Mount Vernon WA 98273-2687. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bradford, Kathy Y can be contacted via phone (360) 899-4086.

Contact Information

Primary practice address
1420 Roosevelt Ave Ste 4 Mount Vernon WA 98273-2687
Phone: (360) 899-4086
Fax: (360) 899-4124
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP60172219 Washington

Profile Details

NPI number 1871802769
LBN Legal business name Bradford, Kathy Y
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2010
Last updated May 7th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871802769 NPPES
Washington Other 12194699 CAQH
Washington MEDICAID 2024980 CAQH
Washington Other 0296462 CAQH

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