Individual
BRIAN GERALD TILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1959 NE PACIFIC ST, C-212, BOX 356340, SEATTLE, WA 98195-6340
(206) 543-0065
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
MD00044590
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0237017
L&I
WA
05
—
1902917974
—
WA
Enumeration date
08/31/2006
Last updated
11/09/2012
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