Provider Demographics
NPI:1679383244
Name:STOCKTON, BRYAN PATRICK (ND)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:PATRICK
Last Name:STOCKTON
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9326 NE 173RD ST
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3614
Mailing Address - Country:US
Mailing Address - Phone:530-559-2887
Mailing Address - Fax:
Practice Address - Street 1:5470 SHILSHOLE AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4040
Practice Address - Country:US
Practice Address - Phone:530-559-2887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61634866175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath