Bradley, Mary
Bradley, Mary is an sole proprietor health care provider with primary practice located at 2422 96Th St S Apt J105 , Tacoma WA 98444-1782. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is her primary health care specialty. Bradley, Mary can be contacted via phone (805) 217-5654.Contact Information
Primary practice address
2422 96Th St S Apt J105
Tacoma WA 98444-1782
Phone: (805) 217-5654
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | CG60735677 | Washington |
| Other Service Providers / Peer Specialist | 175T00000X | CG60735677 | Washington |
Profile Details
| NPI number | 1568934420 |
|---|---|
| LBN Legal business name | Bradley, Mary |
| Credentials | CG60735677 |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 17th, 2018 |
| Last updated | Jul 22nd, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568934420 | NPPES |
| Washington | MEDICAID | CG60735677 |
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