Provider Demographics
NPI:1780697631
Name:BAILEY, BRET A (DC)
Entity type:Individual
Prefix:DR
First Name:BRET
Middle Name:A
Last Name:BAILEY
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 1:3333 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-8497
Mailing Address - Country:US
Mailing Address - Phone:509-430-6365
Mailing Address - Fax:
Practice Address - Street 1:2000 N COLUMBIA CENTER BLVD
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1147
Practice Address - Country:US
Practice Address - Phone:509-783-3191
Practice Address - Fax:509-783-3193
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH0034376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2031276Medicaid