Lightfoot, Bradley J

Lightfoot, Bradley J is an individual health care provider with primary practice located at 2606 116Th Ave Ne Ste 100 , Bellevue WA 98004-1422. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lightfoot, Bradley J can be contacted via phone (425) 462-7664.

Contact Information

Primary practice address
2606 116Th Ave Ne Ste 100 Bellevue WA 98004-1422
Phone: (425) 462-7664
Fax: (425) 462-6429
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X AT2798 Oregon
Eye and Vision Services Providers / Optometrist 152W00000X OPTT308 Alaska
Eye and Vision Services Providers / Optometrist 152W00000X OD00003839 Washington

Profile Details

NPI number 1144229394
LBN Legal business name Lightfoot, Bradley J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Dec 7th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144229394 NPPES
Oregon MEDICAID 1144229394
Oregon MEDICAID 1023294
Oregon MEDICAID 2028348

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