Individual
BRIAN J BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7210 40TH ST W, STE 100, UNIVERSITY PLACE, WA 98466-4318
(253) 564-0170
(253) 207-4240
Mailing address
7210 40TH ST W, STE 100, UNIVERSITY PLACE, WA 98466-4318
(253) 564-0170
(253) 207-4240
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00024170
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0129626
STATE L&I
WA
01
—
0192336
STATE L&I
WA
01
—
0205806
STATE L&I
WA
05
—
1021823
—
WA
01
—
370013712
RAILROAD
WA
01
—
8930009
STATE CRIME VICTIMS
WA
01
—
8939534
STATE CRIME VICTIMS
WA
01
—
8940788
STATE CRIME VICTIMS
WA
Enumeration date
08/05/2006
Last updated
11/16/2010
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