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Individual

MR. BRADLY J EDGERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D., CCC-A

Contact information

Practice address
1405 SE 164TH AVE STE 102, VANCOUVER, WA 98683-9644
(360) 256-4425
(360) 260-7249
Mailing address
1405 SE 164TH AVE STE 102, VANCOUVER, WA 98683-9644
(360) 256-4425
(360) 260-7249

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
LD00001333
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0117625
WA DEPT OF L&I
WA
05
182440
OR
01
4520896
AETNA
WA
01
8935297
WA CRIME VICTIMS
WA
05
9059056
WA
Enumeration date
10/04/2006
Last updated
07/17/2014
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