Provider Demographics
NPI:1619005022
Name:PERRY, BRIAN ROBERT (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ROBERT
Last Name:PERRY
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 WESTERN AVE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3605
Mailing Address - Country:US
Mailing Address - Phone:206-838-1160
Mailing Address - Fax:
Practice Address - Street 1:911 WESTERN AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3605
Practice Address - Country:US
Practice Address - Phone:206-838-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC2676171100000X
WANT1360175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath