Individual
MARK W BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3624 ENSIGN RD NE STE D, OLYMPIA, WA 98506-5074
(360) 459-7713
(360) 459-5441
Mailing address
3624 ENSIGN RD NE STE D, OLYMPIA, WA 98506-5074
(360) 459-7713
(360) 459-5441
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/21/2006
Last updated
12/21/2011
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