Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD00041963 | WA |
NPI | 1104859081 |
---|---|
Provider Name | Dr. Brian L Ferris |
First Address | Bellevue, WA 98004-4623 |
Second Address | Bellevue, WA 98004-4623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 03/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8358657 | (05) | WA |
H83928 | (02) | |
P00033640 | RR MEDICARE (01) | WA |