Marti K Bradley, MSW ACSW LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00006668 Issued in WA

Practice address

30 W Main St Ste 207
Walla Walla, WA 99362

Phone

(509) 876-0100

Fax

(509) 925-2008

NPI assigned

Aug 11, 2006

Sex

Female

Sole proprietor

Yes

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)

Enrolled

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1184635146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST STE 207",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622872",
            "telephone_number": "509-876-0100",
            "fax_number": "509-925-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST STE 207",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-876-0100",
            "fax_number": "509-925-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MARTI",
        "middle_name": "K",
        "credential": "MSW ACSW LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Lynn Boyd, CLINICAL SOCIAL WORK
• Evelyn Barbara Boyd, M.A. CCC-SLP
• James Boyd
• Autumn Ciera Boyle
• Christa Bradford, RN
• Robert John Brawders, PHARMD
• Ai Breithaupt, LMT
• William Michael Breland, MD
• Lynda Jaye Bren, B.S. R.N.
• Erin Aleta Brennan, A.T.,C

• Clinical Social Worker in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.