Powell, John Bradford

Powell, John Bradford is an individual health care provider with primary practice located at 2118 Caton Way Sw , Olympia WA 98502. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Powell, John Bradford can be contacted via phone (360) 352-4602.

Contact Information

Primary practice address
2118 Caton Way Sw Olympia WA 98502
Phone: (360) 352-4602
Fax: (360) 352-3289
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2082 Washington
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2082 Washington

Profile Details

NPI number 1194793737
LBN Legal business name Powell, John Bradford
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Aug 22nd, 2018 - about 8 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 1194793737 NPPES
Washington MEDICAID 2048911

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