Provider Demographics
NPI:1770353872
Name:BRADBURY, CASHMERE QUINN (BA, SUDPT)
Entity type:Individual
Prefix:
First Name:CASHMERE
Middle Name:QUINN
Last Name:BRADBURY
Suffix:
Gender:F
Credentials:BA, SUDPT
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:RENEE
Other - Last Name:SHACKELFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, SUDPT
Mailing Address - Street 1:12311 32ND AVE NE APT 718
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5770
Mailing Address - Country:US
Mailing Address - Phone:520-403-0615
Mailing Address - Fax:
Practice Address - Street 1:4232 198TH ST SW
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6747
Practice Address - Country:US
Practice Address - Phone:425-248-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61490408101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)