Individual
MR. BRADLEY JOSEPH NYSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER, 9040 REID ST., ATTN: MCHJ-QCR, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278
Mailing address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00006484
WA
Other
Enumeration date
10/09/2007
Last updated
02/20/2019
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