Individual
BRADLEY W WINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 MEALS AVE, VALDEZ, AK 99686-0046
(907) 835-2249
Mailing address
6615 HILLTOP LN SW, LAKEWOOD, WA 98499-1426
(316) 516-6170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
913315
AK
207Q00000X
Family Medicine Physician
MD.MD61653822
WA
Other
Enumeration date
04/16/2019
Last updated
08/23/2025
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