Individual
BRADFORD BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
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
Update your record
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