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DR. JOHN BRADFORD POWELL PH.D.

Clinical Neuropsychologist

Olympia, Washington

Provider NPI: 1194793737

Provider Information:
DR. JOHN BRADFORD POWELL PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
1800 COOPER POINT RD SW BLDG 17 OLYMPIA, WA 98502 US
Tel: 360-352-4602  Fax: 360-352-3289

Business Mailing Address:
7825 CANTERWOOD DR SE  OLYMPIA, WA 98513 US
Tel: 360-491-1705  Fax: 360-459-3454

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
WA2082
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
WA2082

Other Provider Identifiers:

IssuerNumberStateType
AB09984WA04
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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