MS. MARY BRADLEY CG60735677 NPI 1568934420

NPI Information

NPI: 1568934420
Provider Name: MS. MARY BRADLEY, CG60735677
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
2422 96TH ST S APT J105
TACOMA, WA
ZIP 98444
Phone: (805) 217-5654
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MS. Mary Bradley, CG60735677 is a peer specialist in Tacoma, WA. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. MS. Mary Bradley, CG60735677 NPI is 1568934420. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2422 96TH ST S APT J105
TACOMA, WA
ZIP 98444-782
Phone: (805) 217-5654

The enumeration date for this NPI number is 12/17/2018 and was last updated on 7/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	CG60735677	WASHINGTON	No
2	175T00000X	Peer Specialist		CG60735677	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CG60735677	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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