Provider Demographics
NPI:1306209705
Name:ESTILL, BRYAN (MD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:ESTILL
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 1:1959 NE PACIFIC ST # BB-1469
Mailing Address - Street 2:UW DEPT OF ANESTHESIOLOGY AND PAIN MEDICINE BOX 356540
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6540
Mailing Address - Country:US
Mailing Address - Phone:206-543-2673
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST # BB-1469
Practice Address - Street 2:UW DEPT OF ANESTHESIOLOGY AND PAIN MEDICINE BOX 356540
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6540
Practice Address - Country:US
Practice Address - Phone:206-543-2673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WAML60661888207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program