Individual
MS. SHELLEY MARIE BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
169 S STEVENS ST STE 101, SUITE 101, SPOKANE, WA 99201-1200
(509) 939-4648
(321) 260-6634
Mailing address
169 S STEVENS ST STE 101, SUITE 101, SPOKANE, WA 99201-1200
(509) 939-4648
(321) 260-5100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA5184
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074607
L&I PROVIDER #
WA
01
—
200066455
FEDERAL TAX ID #
—
Enumeration date
10/26/2006
Last updated
12/04/2015
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