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General NPI Number Information
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NPI Number | 1215126974
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Entity Type | Organization
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Legal Business Name | BRYAN MORRIS-WARD MD PLLC
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 520 LILLY RD NE BLDG 3
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City | OLYMPIA
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State | WA
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Zip | 98506-5102
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Country | US
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Telephone | 360-486-0617
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Fax | 360-486-0621
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Provider Business Mailing Address
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Address Line | 1401 MARVIN RD NE #307 PMB 266
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City | LACEY
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State | WA
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Zip | 98516-5749
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Country | US
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Telephone | 360-491-5055
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Fax | 360-491-5890
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. BRYAN C MORRIS-WARD
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Credential | M.D.
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Telephone | 360-486-0617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00028839
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License Number State | WA
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