Provider Demographics
NPI:1710039631
Name:STEINFELD, BRADLEY I (PSYCH)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:I
Last Name:STEINFELD
Suffix:
Gender:M
Credentials:PSYCH
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 34584
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1584
Mailing Address - Country:US
Mailing Address - Phone:509-241-7349
Mailing Address - Fax:509-241-7628
Practice Address - Street 1:4301 S PINE ST
Practice Address - Street 2:STE 301
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7264
Practice Address - Country:US
Practice Address - Phone:253-476-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00000903103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8432262Medicaid
WAG8881826Medicare PIN
WAGAB28610Medicare PIN
WAGAB28608Medicare PIN
WAGAB78606Medicare PIN
WAR87998Medicare UPIN
WAG8882966Medicare PIN
WA8432262Medicaid
WAGAB17607Medicare PIN