Individual provider · Type 1 NPI

Laine Bradley, PA-S

Student in an Organized Health Care Education/Training Program · Salt Lake City, UT

NPI number 1689524787 Active

Practice location

295 S Chipeta Way Ste 22
Salt Lake City, UT 84108-1234

Call (385) 415-9275 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1689524787

Laine Bradley, PA-S's National Provider Identifier is 1689524787, issued on Jan 29, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Salt Lake City, UT. The record was last updated on Jan 29, 2026.