Individual
DR. BRYAN DAVID EDGINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1331 NW LOVEJOY ST STE 750, PORTLAND, OR 97209
(503) 535-2883
(503) 535-2887
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(603) 242-3008
(360) 807-7687
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
M13975
ID
207W00000X
Ophthalmology Physician
Primary
MD159840
OR
207W00000X
Ophthalmology Physician
MD60801522
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20013225
MEDICARE ID
ID
05
—
20013225
—
ID
05
—
2021463
—
WA
05
—
500649006
—
OR
01
—
G8975733
MEDICARE WA
WA
01
—
G8975734
MEDICARE WA
WA
01
—
G8975735
MEDICARE WA
WA
01
—
G8975736
MEDICARE WA
WA
01
—
G8975737
MEDICARE WA
WA
01
—
R199916
MEDICARE OR
OR
Enumeration date
02/08/2006
Last updated
07/18/2022
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