Provider Demographics
NPI:1033207253
Name:MARUHASHI, BRYAN GENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:GENE
Last Name:MARUHASHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2955 80TH AVE SE STE 203
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2975
Mailing Address - Country:US
Mailing Address - Phone:206-232-3010
Mailing Address - Fax:206-232-1118
Practice Address - Street 1:2955 80TH AVE SE STE 203
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-2975
Practice Address - Country:US
Practice Address - Phone:206-232-3010
Practice Address - Fax:206-232-1118
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00006294122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA91-1535230OtherTAX ID