MEDICARE: DR. HOWARD BERRYMAN EDWARDS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0802X	Addiction Psychiatry Physician	MD00022387	WA

General Provider Information

NPI Number	:	1609915685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD BERRYMAN EDWARDS M.D.

Provider Business Mailing Address
First Line	:	14205 SE 36TH ST
Second Line	:	100
City	:	BELLEVUE
State	:	WA
Zip	:	98006-1596
Country	:	US
Telephone Number	:	425-998-6123
Fax Number	:

Provider Business Practice Location Address
First Line	:	14205 SE 36TH ST
Second Line	:	100
City	:	BELLEVUE
State	:	WA
Zip	:	98006-1596
Country	:	US
Telephone Number	:	425-998-6123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	09/28/2015

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