Individual
BRADLEY LAWRENCE AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SUDPT
Contact information
Practice address
235 S 3RD ST, SHELTON, WA 98584-2255
(360) 426-0890
(360) 426-4688
Mailing address
1024 PROSPECT AVE NE APT 8, OLYMPIA, WA 98506-4079
(360) 972-4604
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C061511120
WA
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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