Bradford J Brouillette, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00008159 Issued in WA

Practice address

410 W Poplar St.
Rehabilitation Services
Walla Walla, WA 99362

Phone

(509) 897-3320

Fax

(509) 897-5752

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Providence Health & Services - Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Washington

  • Neurological Surgery Physician
  • Walla Walla, WA
  • NPI 1760636690
  NPD
• Inland Physical Therapy and Sports Rehab

  • Physical Therapist
  • Spokane Valley, WA
  • NPI 1407933609
  NPD (past)
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  NPD (past)
• T Daniel Dibble MD PC

  • Interventional Pain Medicine Physician
  • Spokane, WA
  • NPI 1346082344
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1861589350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W POPLAR ST.",
            "address_2": "REHABILITATION SERVICES",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-897-3320",
            "fax_number": "509-897-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W POPLAR ST.",
            "address_2": "REHABILITATION SERVICES",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "99362",
            "telephone_number": "509-897-3320",
            "fax_number": "509-897-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "BRADFORD",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00008159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian W Rich
• Alayna M Brinton, MSW, LICSW
• Parker Brooke, MSCPCC, AAC, SUDP
• Hailey Rae Brooks
• Jeannine Broome, PT
• Shaelyn Broussard
• Cynthia Brown, MA, CCC-SLP
• Darlene Turner Brown, ARNP
• Eric Trent Brown, M.D.
• Lori Alborn Brown, MD

• Physical Therapist in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.