Provider Demographics
NPI:1831241918
Name:BRADFORD, HEATHER MARIE (MSN, CNM, ARNP)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MARIE
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:MSN, CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6528
Mailing Address - Country:US
Mailing Address - Phone:425-803-3337
Mailing Address - Fax:
Practice Address - Street 1:12303 NE 130TH LN STE 500
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3059
Practice Address - Country:US
Practice Address - Phone:425-899-4455
Practice Address - Fax:425-899-4434
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006163367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife