Provider Demographics
NPI:1326025370
Name:EIFERT, BRIAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:EIFERT
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 1:820 N CHELAN AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 S. MILLER STREET
Practice Address - Street 2:CENTRAL WASHINGTON HOSPITAL
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98807-1887
Practice Address - Country:US
Practice Address - Phone:509-665-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000441742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA188861OtherL&I PROVIDER NUMBER
WA188862OtherL&I PROVIDER NUMBER
WA8406548Medicaid
WA188860OtherL&I PROVIDER NUMBER
WA8807249Medicare ID - Type UnspecifiedPROVIDER NUMBER
WA8807251Medicare ID - Type UnspecifiedPROVIDER NUMBER
WA8807253Medicare ID - Type UnspecifiedPROVIDER NUMBER
WA8807255Medicare ID - Type UnspecifiedPROVIDER NUMBER
WA8406548Medicaid
WAE16354Medicare UPIN