SHANNON BRADBURN (NPI# 1679958268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679958268 |
| Entity Type | Individual |
| Full Name | SHANNON BRADBURN |
| Practice Address |
402 S 4th Ave Yakima WA 98902 |
| Mailing Address |
Po Box 959 Yakima WA 98907-0959 |
| Practice Telephone | 5095754084 |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2018-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
402 S 4TH AVE |
| City | YAKIMA |
| State | WA |
| Zip Code | 98902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811996200 | John Edward Omalley | Psychiatry & Neurology | 402 S 4th Ave, Yakima, WA 98902-3546 | 2005-07-18 |
| 1407453715 | Mariah Forgey | Social Worker | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-10-08 |
| 1821602251 | David Mejia Juarez | Case Manager/Care Coordinator | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-09-02 |
| 1184238503 | Aleque Fraser-robinson | Peer Specialist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-09-02 |
| 1093326498 | Casey Eugene Olson | Pharmacist | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-08-11 |
| 1891305124 | Whitney Gregory | Social Worker | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-08-02 |
| 1053936203 | Paulina Alcala | Case Manager/Care Coordinator | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-06-13 |
| 1972128122 | Mercedes Cardenas | Case Manager/Care Coordinator | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-06-13 |
| 1699390849 | Luis Garcia | Case Manager/Care Coordinator | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-06-13 |
| 1134744386 | Cynthia Deleon | Counselor | 402 S 4th Ave, Yakima, WA 98902-3546 | 2020-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653203 | Laboratory Corporation of America | Clinical Medical Laboratory | 314 S 11th Ave Suite A, Yakima, WA 98902 | 2019-08-05 |
| 1669967865 | Rebecca Schrader | Speech-Language Pathologist | Children's Village 3801 Kern Road, Yakima, WA 98902 | 2018-06-29 |
| 1720572928 | Hyperbaric Centers of Washington | Preventive Medicine | 302 S. 12th Ave., Yakima, WA 98902 | 2018-06-20 |
| 1487155503 | Courtney Lombardi | Nurse Practitioner | 1515 W Yakima Ave, Yakima, WA 98902 | 2018-02-23 |
| 1003329665 | Maria-elena Mendoza | Case Manager/Care Coordinator | 918 E Mead Avenue, Yakima, WA 98902 | 2017-11-06 |
| 1679017610 | Claudia Zepeda | Massage Therapist | 3908 Creekside Loop Ste # 110, Yakima, WA 98902 | 2016-12-09 |
| 1093194425 | Silas Klaver | Podiatrist | 1607 Creekside Loop Ste 140, Yakima, WA 98902 | 2015-05-18 |
| 1821490905 | Jen Lynn Silver | Massage Therapist | 3512 Tieton Dr, Yakima, WA 98902 | 2014-09-20 |
| 1194131383 | Brenna Claire Hayes | Genetic Counselor, MS | 2903 W Walnut, Yakima, WA 98902 | 2014-07-08 |
| 1720400435 | Agnes Nadine Jeske | Speech-Language Pathologist | 621 S. 13th Ave., Mckinley Elementary School, Yakima, WA 98902 | 2014-01-15 |
| Find all providers in zip 98902 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952918765 | Theresa A Hoisington-yanez | Counselor | 421 S 43rd St, Yakima, WA 98901-1504 | 2020-09-25 |
| 1699391573 | Guadalupe V Bazan Jr. | Counselor | 609 W Logan Ave, Yakima, WA 98902-5553 | 2020-06-17 |
| 1063977692 | Diana Lane Dewey | Counselor | 102 N 48th Ave, Yakima, WA 98908-3134 | 2019-02-07 |
| 1053875625 | Amanda Rose Rodriguez | Counselor | 1410 W Prasch Ave, Yakima, WA 98902-5377 | 2019-01-28 |
| 1720558711 | William Blair Ellis Jr. | Counselor | 611 W A St, Yakima, WA 98902-2605 | 2018-12-03 |
| 1427526524 | Tammy A. Kinter | Counselor | 7610 W Nob Hill Blvd Unit 231, Yakima, WA 98908-1942 | 2018-11-06 |
| 1760959290 | Conswaylo Ann Fleek | Counselor | 120 S. 3rd Ave., Yakima, WA 98901 | 2018-11-02 |
| 1366919359 | Laura Ann Johnston | Counselor | 605 Superior Ln, Yakima, WA 98902-1623 | 2018-10-27 |
| 1396212718 | Nancy Fraser | Counselor | 120 S. 3rd Street, Yakima, WA 98901 | 2018-10-24 |
| 1265916837 | Jasmine Nathaley Barrera-ledezma | Counselor | 2000 W Lincoln Ave Apt 19, Yakima, WA 98902-2477 | 2018-09-19 |
| Find all providers in YAKIMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.