Individual
DR. BRADLEY J LIGHTFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2606 116TH AVE NE STE 100, BELLEVUE, WA 98004-1422
(425) 462-7664
(425) 462-6429
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(360) 807-7687
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
AT2798
OR
152W00000X
Optometrist
Primary
OD00003839
WA
152W00000X
Optometrist
OPTT308
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023294
—
AK
05
—
1144229394
—
OR
05
—
2028348
—
WA
Enumeration date
07/19/2005
Last updated
12/07/2020
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