Individual
BRADFORD BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
15623 1ST AVE S STE C, BURIEN, WA 98148-1292
(206) 444-6320
(206) 444-6302
Mailing address
808 3RD AVE N, SEATTLE, WA 98109-3707
(206) 444-6320
(206) 444-6302
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007787
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0142606
DEPT OF L&I
WA
01
—
1598725798
NPI GROUP NUMBER
WA
01
—
5122997
CIGNA
WA
01
—
5411BE
REGENCE BLUE
WA
05
—
7104300
—
WA
01
—
8865497
MEDICARE (GROUP #)
WA
01
—
8865765
MEDICARE -NEW IND. NUMBER
WA
01
—
912117273
TAX ID
WA
Enumeration date
01/04/2007
Last updated
03/07/2022
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