Healthcare Provider Details

I. General information

NPI: 1891228656
Provider Name (Legal Business Name): BRIAN MUGLESTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2017
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11567 CANTERWOOD BLVD
GIG HARBOR WA
98332-5812
US

IV. Provider business mailing address

13302 PURDY DR NW
GIG HARBOR WA
98332-8636
US

V. Phone/Fax

Practice location:
  • Phone: 253-857-1320
  • Fax:
Mailing address:
  • Phone: 253-961-4648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD61139323
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: