Healthcare Provider Details

I. General information

NPI: 1386845899
Provider Name (Legal Business Name): ANGELA ROMAN BRYAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA CHRISTINE ROMAN

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA WA
98431-0001
US

IV. Provider business mailing address

MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
TACOMA WA
98431-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-2310
  • Fax: 253-968-5294
Mailing address:
  • Phone: 253-968-2310
  • Fax: 253-968-5294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number60859240
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: