Provider Demographics
NPI:1902836950
Name:CRYST, CYRUS (MD)
Entity Type:Individual
Prefix:
First Name:CYRUS
Middle Name:
Last Name:CRYST
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 1:1100 9TH AVE
Mailing Address - Street 2:MS M4-PA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-583-6025
Mailing Address - Fax:206-515-5886
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023186207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUS4268292OtherAETNA/USHC SPECIALIST
WA8135527Medicaid
WA0039589OtherLABOR & INDUSTRY
WAUS0819027OtherAETNA/USHC PCP
WACR8743OtherBLUE SHIELD
WAMD8623OtherALASKA MEDICAID
WA8800221Medicare PIN
WA8808805Medicare PIN
WA0039589OtherLABOR & INDUSTRY
WA8135527Medicaid