Individual provider Active NPI

Bradley Borgkvist, CRNA

  • Certified Registered Nurse Anesthetist
  • Tacoma, WA
National Provider Identifier
1487100335
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP61146909 Issued in WA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-4504
Phone
(910) 286-7128
NPI assigned
Aug 31, 2016
Last updated
Feb 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 768950 TX
Certified Registered Nurse Anesthetist 367500000X AP61146909 WA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-4504

Mailing address

3551 Roger Brooke Dr
Usagpan McHe-ZSD
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 539-9204

Other practice location 1

209 Lilly Rd NE
Olympia, WA 98506-5030
Phone (360) 413-8250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305001474 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779065032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10343 Wildwood LN SE
Olympia, WA 98513-9244

9500 S Dadeland Blvd
Suite 200
Miami, FL 33156-2866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP61146909WAMDCertified Registered Nurse Anesthetist
768950TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates Clinical Practice, PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 20, 2026 Accepting new patients

Locations

209 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8250

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1487100335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "USAGPAN MCHE-ZSD",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984314504",
            "telephone_number": "910-286-7128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065030",
            "country_code": "US",
            "telephone_number": "360-413-8250",
            "fax_number": "360-413-8850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORGKVIST",
        "first_name": "BRADLEY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "768950",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61146909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.