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Individual

BRAD S DEFENBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1 LAKE BELLEVUE DR, STE 100, BELLEVUE, WA 98005-2417
(425) 462-4330
(425) 462-4335
Mailing address
1 LAKE BELLEVUE DR, STE 100, BELLEVUE, WA 98005-2417
(425) 462-4330
(425) 462-4335

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60273792
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070016925
ILLINOIS PT LICENSE
IL
Enumeration date
02/24/2009
Last updated
11/11/2019
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