Provider Demographics
NPI:1225256001
Name:WEST, BRADLEY RUSSELL (ND)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:RUSSELL
Last Name:WEST
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1665
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95031-1665
Mailing Address - Country:US
Mailing Address - Phone:831-332-0143
Mailing Address - Fax:
Practice Address - Street 1:244 OAK MEADOW DR
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-4452
Practice Address - Country:US
Practice Address - Phone:831-332-0143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath