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General NPI Number Information
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NPI Number | 1114160108
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Entity Type | Individual
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Provider Name | BRIAN MYATT
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Gender | Male
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 4245 ROOSEVELT WAY NE UWMC ROOSEVELT CLINIC - VIROLOGY
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City | SEATTLE
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State | WA
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Zip | 98105
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Country | US
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Telephone | 206-598-4368
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Fax |
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Provider Business Mailing Address
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Address Line | 1623 TAYLOR AVE. N. #105
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City | SEATTLE
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State | WA
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Zip | 98109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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