Individual
DR. BRETT RUSSELL STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4225 ROOSEVELT WAY NE FL 4, SEATTLE, WA 98105-6099
(206) 598-4282
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD60503012
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003844226
—
WA
Enumeration date
06/28/2006
Last updated
10/22/2019
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