Individual provider Active NPI

Tracy Bradley, ARNP

  • Pediatric Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1124151600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP30004071 Issued in WA
Practice address
4800 Sand Point Way NE
B-6553
Seattle, WA 98105-3901
Phone
(206) 987-4427
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP30004071 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
B-6553
Seattle, WA 98105-3901

Mailing address

735 35TH Ave
Seattle, WA 98122-5203
Phone (206) 323-2191

Other identifiers 3

IdentifierTypeStateIssuer
NP071WAMedicaidAK
807611900MedicaidID
9650284MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070530000329 WA Practitioner - Nurse Practitioner 6709776339 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30004071WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians CurrentSince Jan 22, 2022 Accepting new patients
Seattle Childrens Hospital CurrentSince Oct 3, 2017 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Jan 22, 2022 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

4800 Sand Point Way NE
#B6553
Seattle, WA 98105
Phone (206) 987-2106

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124151600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 35TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225203",
            "telephone_number": "206-323-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "B-6553",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "TRACY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP30004071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP071WA",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807611900",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9650284",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.