Individual
DR. ROBERT A. BREZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
Mailing address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
60367833
WA
2085R0202X
Diagnostic Radiology Physician
MD205146
OR
2085R0202X
Diagnostic Radiology Physician
Primary
MD60367833
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386818516
—
WA
05
—
2029135
—
WA
01
—
340864
LNI PROVIDER ID
WA
01
—
340865
LNI PROVIDER ID
WA
01
—
340866
LNI PROVIDER ID
WA
01
—
340867
LNI PROVIDER ID
WA
Enumeration date
04/18/2008
Last updated
08/29/2024
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