Organization
MARK W BRADFORD MD INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WAYNE BRADFORD MD (PRESIDENT)
(360) 459-7713
Entity
Organization
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
261Q00000X
Clinic/Center
Primary
MD0019897
WA
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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