Provider Demographics
NPI:1942276258
Name:SERKIN, BRYAN SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:SAMUEL
Last Name:SERKIN
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 1:400 S 43RD ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-5714
Mailing Address - Country:US
Mailing Address - Phone:206-575-2602
Mailing Address - Fax:206-575-2607
Practice Address - Street 1:4033 TALBOT RD S
Practice Address - Street 2:STE 540
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5772
Practice Address - Country:US
Practice Address - Phone:206-575-2602
Practice Address - Fax:206-575-2607
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60144417207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology