Provider Demographics
NPI:1942377502
Name:CAREY, BRIAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:CAREY
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 1506
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0409
Mailing Address - Country:US
Mailing Address - Phone:360-242-3008
Mailing Address - Fax:360-807-7687
Practice Address - Street 1:2606 116TH AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1422
Practice Address - Country:US
Practice Address - Phone:425-462-7664
Practice Address - Fax:425-462-6429
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-11172207W00000X
AKMEDS7014207W00000X
MTMED-PHYS-LIC-12529207W00000X
ORMD151666207W00000X
WAMD00030634207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1196391OtherMEDICARE ID
ID1942377502Medicaid
WAG8891649OtherMEDICARE WA
WAG8891650OtherMEDICARE WA
ORR157914OtherMEDICARE OR
OR500631174Medicaid
WAG8891651OtherMEDICARE WA
MTM011000543OtherMEDICARE MT
MT1942377502Medicaid
WA2007770Medicaid
WAG8891654OtherMEDICARE WA
AK1571087Medicaid
WAG8891652OtherMEDICARE WA
AKK163385OtherMEDICARE AK