Provider Demographics
NPI:1558397265
Name:BUCHMILLER, BRETT L (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:L
Last Name:BUCHMILLER
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:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-258-3900
Mailing Address - Fax:425-258-3910
Practice Address - Street 1:2901 174TH ST NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-4743
Practice Address - Country:US
Practice Address - Phone:360-454-1912
Practice Address - Fax:360-454-1985
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0055207K00000X, 207R00000X, 208000000X
WAMD60282454207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2017491Medicaid
TX930108094OtherRAILROAD MEDICARE
TX144365701Medicaid
TX144365701Medicaid
TX930108094OtherRAILROAD MEDICARE
TXH38264Medicare UPIN