Provider Demographics
NPI:1407854706
Name:GARRIE, STUART (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:
Last Name:GARRIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STUART
Other - Middle Name:A
Other - Last Name:GARRIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:113 CEDAR CREST LN
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6725
Mailing Address - Country:US
Mailing Address - Phone:425-457-0353
Mailing Address - Fax:
Practice Address - Street 1:113 CEDAR CREST LN
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6725
Practice Address - Country:US
Practice Address - Phone:425-457-0353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00015213207N00000X, 207ND0900X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1407854706OtherMEDICARE NPI
WAAG7768875OtherPRESCRIPTION AUTHORITY
WAMD00015213OtherMEDICAL LICENSE
WAAG7768875OtherPRESCRIPTION AUTHORITY