| Mark W Bradford Md Inc Ps | |
|
3624 Ensign Rd Ne Ste D Olympia WA 98506-5074 | |
| (360) 459-7713 | |
| (360) 459-5441 |
| Full Name | Mark W Bradford Md Inc Ps |
|---|---|
| Speciality | Clinic/center |
| Location | 3624 Ensign Rd Ne Ste D, Olympia, Washington |
| Authorized Official Name and Position | Mark Wayne Bradford (PRESIDENT) |
| Authorized Official Contact | 3604597713 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark W Bradford Md Inc Ps 3624 Ensign Rd Ne Ste D Olympia WA 98506-5074 Ph: (360) 459-7713 | Mark W Bradford Md Inc Ps 3624 Ensign Rd Ne Ste D Olympia WA 98506-5074 Ph: (360) 459-7713 |
| NPI Number | 1619241346 |
|---|---|
| Provider Enumeration Date | 02/27/2012 |
| Last Update Date | 02/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619241346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD0019897 (Washington) | Primary |
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