Individual
DR. BRIAN P. FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. / M.P.H.
Contact information
Practice address
1405 DELAWARE ST, LONGVIEW, WA 98632-2326
(360) 414-2329
Mailing address
1115 SE 164TH AVE, DEPT. 358, VANCOUVER, WA 98683-9324
(360) 414-2329
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
MD00049070
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD00049070
STATE LICENSE
WA
Enumeration date
01/03/2007
Last updated
03/03/2016
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