Provider Demographics
NPI:1508417536
Name:ORGAN, BRIAN MACARAIG
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:MACARAIG
Last Name:ORGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 DEXTER AVE N OFC 12
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3534
Mailing Address - Country:US
Mailing Address - Phone:580-969-0008
Mailing Address - Fax:
Practice Address - Street 1:1425 DEXTER AVE N OFC 12
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-3534
Practice Address - Country:US
Practice Address - Phone:580-969-0008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-20
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95286394163W00000X
WAAP70008704363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse