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1225147218
BRADLEY A TATE
VANCOUVER, WA
NPI
1225147218
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
156FX1800X Technician/Technologist, Optician
(Licence: OR CERTEFIED)
Enumeration Date
2006-08-30
Last Update Date
2007-07-08
Business Address
-- BRADLEY A TATE
14406 NE 20TH AVE
VANCOUVER, WA 98686-1448
Phone number: 360-571-3084
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Mailing Address
-- BRADLEY A TATE
15311 SE BYBEE DR
PORTLAND, OR 97236-7858
Phone number: 503-621-6889
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