Individual
BRIAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
820 NW 95TH ST, SEATTLE, WA 98117-2207
(206) 782-0100
Mailing address
1711 E OLIVE WAY APT 417, SEATTLE, WA 98102-5684
(206) 979-7939
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1.160852132
WA
Other
Enumeration date
12/22/2023
Last updated
12/22/2023
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