Active NPI
Marlene Bradow
- Registered Nurse
- Port Angeles, WA
National Provider Identifier
1104251487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN60087471
- Practice address
- 4614 S Fey Rd
Port Angeles, WA 98363-9466 - Phone
- (360) 460-4107
- NPI assigned
- Sep 5, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN60087471 | WA | Primary |
Addresses
Primary practice location
4614 S Fey Rd
Port Angeles, WA 98363-9466
Mailing address
4614 Fey Rd
Port Angeles, WA 98363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN60087471 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378339200000",
"number": "1104251487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4614 FEY RD",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "98363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4614 S FEY RD",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983639466",
"telephone_number": "360-460-4107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADOW",
"first_name": "MARLENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-05",
"last_updated": "2013-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN60087471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.