Individual
DR. JOHN BRADFORD POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2118 CATON WAY SW, OLYMPIA, WA 98502
(360) 352-4602
(360) 352-3289
Mailing address
2118 CATON WAY SW, OLYMPIA, WA 98502-1105
(360) 352-4602
(360) 352-3289
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2082
WA
103TC0700X
Clinical Psychologist
Primary
2082
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2048911
—
WA
Enumeration date
03/09/2006
Last updated
08/22/2018
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