| Doctor Name: | BRADFORD J BROUILLETTE |
| NPI Number: | 1861589350 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHYSICAL THERAPIST |
| License Number: | PT00008159 |
| Business Practice Address: | 14120 North Newport Hwy Ste B Mead, WA - 990218600 |
| Business Phone Number: | 5094684961 |
| Business Fax Number: | |
| Mailing Address: | 11481 Sw Hall Blvd, Ste 201 PORTLAND |
| State: | OR |
| Postal Code: | 972238403 |
| Phone Number: | 8002198835 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 11/06/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00008159 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |