Active NPI
Henry Lee Bradbury III, PA-C, MPAS
- Physician Assistant
- Bellevue, WA
National Provider Identifier
1609842871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA60623848
- Practice address
- 15585 NE 24TH St
Bellevue, WA 98007-3836 - Phone
- (888) 227-3312
- NPI assigned
- Feb 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA60623848 | WA | Primary |
Addresses
Primary practice location
15585 NE 24TH St
Bellevue, WA 98007-3836
Mailing address
PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA60623848 | WA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466899200000",
"number": "1609842871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25608",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841250608",
"telephone_number": "206-320-4476",
"fax_number": "206-568-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15585 NE 24TH ST",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980073836",
"telephone_number": "888-227-3312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADBURY",
"first_name": "HENRY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "PA-C, MPAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-27",
"last_updated": "2016-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA60623848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.