Provider Demographics
NPI:1457313413
Name:BRULL, JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:BRULL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:22100 BOTHELL EVERETT HWY
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-8431
Mailing Address - Country:US
Mailing Address - Phone:208-416-2932
Mailing Address - Fax:855-673-9190
Practice Address - Street 1:3315 THUNDERBIRD DR
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-1401
Practice Address - Country:US
Practice Address - Phone:855-687-7237
Practice Address - Fax:855-673-9190
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-280552085R0202X
VA01022016022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology