Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH00003296 | WA |
NPI | 1710044797 |
---|---|
Provider Name | Dr. Bryan R R Stewart |
First Address | Edmonds, WA 98020 |
Second Address | Seattle, WA 98117-5508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |