Individual
DR. BRIAN WILLIAM LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1201 N ELM, PRINEVILLE, OR 97754
(541) 447-6254
Mailing address
11436 BRIAN LN NE, POULSBO, WA 98370-7919
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD19148
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8385643
—
WA
Enumeration date
06/26/2006
Last updated
05/19/2008
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