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Individual

MR. BRADLEY GAIL JELLERICHS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.R.N.P.

Contact information

Practice address
737 LOGAN AVE N, RENTON, WA 98057-5535
(312) 544-2000
Mailing address
PO BOX 3707, MC 99-1MD, SEATTLE, WA 98124
(312) 544-2000
(425) 965-3752

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 60023039
WA
207N00000X
Dermatology Physician
60128753
WA
207QA0401X
Addiction Medicine (Family Medicine) Physician
60128753
WA
2083X0100X
Occupational Medicine Physician
AP60128753
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60128753
WA

Other

Enumeration date
12/31/2008
Last updated
03/04/2026
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