| Doctor Name: | STEPHEN BRADLEY |
| NPI Number: | 1134222011 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA10000296 |
| Business Practice Address: | 740 Memorial St Prosser, WA - 993501525 |
| Business Phone Number: | 5097861931 |
| Business Fax Number: | 5097861997 |
| Mailing Address: | Po Box 190, TOPPENISH |
| State: | WA |
| Postal Code: | 989480190 |
| Phone Number: | 5098656175 |
| Fax Number: | |
| NPI Enumeration Date: | 09/06/2006 |
| NPI Last Update Date: | 04/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA10000296 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |