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Individual

BRIAN R MCKILLOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1101 MADISON ST, SUITE 600, SEATTLE, WA 98104-1306
(206) 215-2020
(206) 215-2022
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
MD00015938
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0036111
LABOR & INDUSTRIES
WA
05
8163206
WA
01
M414
REGENCE HEALTHCARE
Enumeration date
12/20/2005
Last updated
03/11/2008
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