Bradley Charles Brosius

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

61075979 Issued in WA

Practice address

5702 N 26TH St Ste a
Tacoma, WA 98407-2406

Phone

(253) 503-6761

NPI assigned

Sep 23, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Navos

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Seattle, WA
  • NPI 1194728105
  NPD

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1184275042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5702 N 26TH ST STE A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984072406",
            "telephone_number": "253-503-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 N 26TH ST STE A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984072406",
            "telephone_number": "253-503-6761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1033 SW 152nd St",
            "address_purpose": "LOCATION",
            "city": "Burien",
            "state": "WA",
            "postal_code": "981661845",
            "country_code": "US",
            "telephone_number": "206-242-1698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROSIUS",
        "first_name": "BRADLEY",
        "middle_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "61075979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.