Individual
BRADLEY KYLE NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2316 EASTGATE ST STE 170, WALLA WALLA, WA 99362-1576
(509) 529-7371
Mailing address
2316 EASTGATE ST STE 170, WALLA WALLA, WA 99362-1576
(509) 529-7371
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3519WA
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2017328
—
WA
05
—
2130268WA
—
WA
Enumeration date
08/14/2006
Last updated
12/18/2025
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