Provider Demographics
NPI:1437291309
Name:HUGHES, HAROLD BRADLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:BRADLEY
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-5761
Mailing Address - Country:US
Mailing Address - Phone:253-833-0860
Mailing Address - Fax:253-939-5444
Practice Address - Street 1:1202 E MAIN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-5761
Practice Address - Country:US
Practice Address - Phone:253-833-0860
Practice Address - Fax:253-939-5444
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0017905OtherLABOR AND INDUSTRIES
WA2085702Medicaid