Mija Bradshaw, SUDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

00003745 Issued in WA

Practice address

3925 8TH Ave SE Ste a
Lacey, WA 98503-1122

Phone

(360) 923-9585

Fax

(888) 310-1691

NPI assigned

Sep 25, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Right Step, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lacey, WA
  • NPI 1659562221
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1053138404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 8TH AVE SE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031122",
            "telephone_number": "360-923-9585",
            "fax_number": "888-310-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 8TH AVE SE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031122",
            "telephone_number": "360-923-9585",
            "fax_number": "888-310-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "MIJA",
        "credential": "SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "00003745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dave Boyd, MFTA
• Danielle Marie Boyko, BACHELOR'S DEGREE
• Irene E Boysen-Phillips, LPN
• Denae Bradburn
• Aprica Bradley
• Hayden Brame
• Kayla Brandt, LMT
• Clara Winona Brannan, DDS
• Anniebelle M Brattrud
• Bravo Mind Psychiatry PLLC

• Addiction (Substance Use Disorder) Counselor in Lacey, WA
• Providers in Lacey, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.