Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 60859240 | WA |
NPI | 1386845899 |
---|---|
Provider Name | Dr. Angela Roman Bryan |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 29/03/2019 |