Provider Demographics
NPI:1851592331
Name:ULRICH, ROBERT BRADLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRADLEY
Last Name:ULRICH
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 1:15935 NE 8TH ST
Mailing Address - Street 2:STE A101
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-3918
Mailing Address - Country:US
Mailing Address - Phone:425-644-5556
Mailing Address - Fax:425-644-3174
Practice Address - Street 1:15935 NE 8TH ST STE A101
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98008-3918
Practice Address - Country:US
Practice Address - Phone:425-644-5556
Practice Address - Fax:425-644-3174
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00033882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0140417OtherDEPARTMENT OF L & I
WAU82472Medicare UPIN
WAGAB21966Medicare ID - Type Unspecified