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General NPI Number Information
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NPI Number | 1962897504
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Entity Type | Individual
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Provider Name | BRIAN DIAL
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Gender | Male
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 12039 NE 128TH ST STE 500
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City | KIRKLAND
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State | WA
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Zip | 98034-3029
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Country | US
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Telephone | 425-899-4930
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Fax | 425-899-4811
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Provider Business Mailing Address
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Address Line | 12039 NE 128TH ST STE 500
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City | KIRKLAND
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State | WA
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Zip | 98034-3029
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Country | US
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Telephone | 254-899-4930
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Fax | 425-899-4811
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 2020010618
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 61150713
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License Number State | WA
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