Individual
BRADLEY J. WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4409 NW ANDERSON HILL RD, SILVERDALE, WA 98383-6807
(360) 698-6630
(360) 698-7002
Mailing address
PO BOX 450, SILVERDALE, WA 98383-0450
(360) 698-6630
(360) 698-7002
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00028061
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0226209
L&I
WA
05
—
8128415
—
WA
01
—
8945708
CRIME VICTIMS
WA
01
—
P00480581
MEDICARE RAILROAD PTAN
WA
Enumeration date
07/03/2006
Last updated
09/03/2013
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