Provider Demographics
NPI:1992892731
Name:MURRAY, BRYAN (MD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:MURRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:360-293-4343
Mailing Address - Fax:
Practice Address - Street 1:912 32ND ST
Practice Address - Street 2:SUITE A
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-3473
Practice Address - Country:US
Practice Address - Phone:360-293-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6252MUOtherREGENCE BLUE SHIELD
WA182406OtherWORKMANS COMP
WA8384786Medicaid
WA8384786Medicaid
WA182406OtherWORKMANS COMP