Individual
BRANT F CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1455 NW LEARY WAY, SUITE 300, SEATTLE, WA 98107-5124
(206) 784-3350
(206) 781-8693
Mailing address
1101 MADISON ST, SUITE 600, SEATTLE, WA 98104-1306
(206) 215-2004
(206) 215-2055
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00036720
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126806
LABOR & INDUSTRIES
WA
01
—
180036318
RAILROAD MEDICARE
—
05
—
8241861
—
WA
01
—
CA3570
REGENCE HEALTHCARE
—
Enumeration date
12/22/2005
Last updated
04/23/2014
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