STEPHEN BRADLEY PA NPI 1134222011

NPI Information

NPI: 1134222011
Provider Name: STEPHEN BRADLEY, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
740 MEMORIAL ST
PROSSER, WA
ZIP 99350
Phone: (509) 786-1931
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Stephen Bradley, PA is a medical physician assistant in Prosser, WA. Stephen Bradley, PA NPI is 1134222011. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

740 MEMORIAL ST
PROSSER, WA
ZIP 99350-525
Phone: (509) 786-1931
Fax: (509) 786-1997

The enumeration date for this NPI number is 9/6/2006 and was last updated on 4/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA10000296	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1306897681	OTHER		NPI PROSSER MEMORIAL
2	142805	OTHER	WASHINGTON	L & I
3	GAB24073	MEDICARE ID-TYPE UNSPECIFIED
4	6972	OTHER		GROUP HEALTH
5	4750BR	OTHER	WASHINGTON	REGENCE
6	R89176	MEDICARE UPIN
7	8296097	OTHER	WASHINGTON	CHPW
8	8296097	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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