MR. BRYAN JAMES ANTONIUS (NPI# 1073985057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073985057 |
| Entity Type | Individual |
| Full Name | MR. BRYAN JAMES ANTONIUS |
| Credential | R.T. |
| Practice Address |
10004 204th Ave E Suite 2600 Bonney Lake WA 98391-6539 |
| Practice Telephone | 2534463983 |
| Practice Fax Number | 2538625004 |
| Mailing Telephone | 2534463983 |
| Mailing Fax Number | 2538625004 |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
CRT-17967 | AZ | Technologists, Technicians & Other Technical Service Providers |
| Y | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
RT 60584477 | WA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
10004 204TH AVE E SUITE 2600 |
| City | BONNEY LAKE |
| State | WA |
| Zip Code | 98391-6539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588656284 | Kelly A Osborn | Physical Therapist | 10004 204th Ave E, Ste 3100, Bonney Lake, WA 98391-6539 | 2005-08-18 |
| 1053946459 | Jean Piere Nieves | Physician Assistant | 10004 204th Ave E, Bonney Lake, WA 98391-6539 | 2020-03-05 |
| 1508408923 | Heidi Rose Heiser | Midwife | 10004 204th Ave E, Bonney Lake, WA 98391-6539 | 2019-10-17 |
| 1881189470 | Kristina Omalley Dubow | Midwife | 10004 204th Ave E, Bonney Lake, WA 98391 | 2018-06-26 |
| 1588115158 | Sujin Lee | Pharmacist | 10004 204th Ave E, Bonney Lake, WA 98391-6539 | 2016-10-19 |
| 1487101994 | Chi Ming Chan | Pharmacist | 10004 204th Ave E, #1100, Bonney Lake, WA 98391-6539 | 2016-09-01 |
| 1487015657 | Kala Gardner | Occupational Therapist | 10004 204th Ave E, Ste 3100, Bonney Lake, WA 98391-6539 | 2016-03-15 |
| 1487023701 | Rachel Pruessing | Physical Therapist | 10004 204th Ave E, Ste 3100, Bonney Lake, WA 98391-6539 | 2015-09-16 |
| 1891161865 | Julia Morris | Nurse Practitioner | 10004 204th Ave E, #3400, Bonney Lake, WA 98391-6539 | 2015-08-13 |
| 1891192282 | Christa Diane Fonda | Dietitian, Registered | 10004 204th Ave E, Bonney Lake, WA 98391-6539 | 2014-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218814 | Lenny Yann | Pharmacist | 21301 Wa 410, Bonney Lake, WA 98391 | 2020-09-08 |
| 1497244552 | Kayla Grasso | Technician, Other | 18444 139th Street East, Bonney Lake, WA 98391 | 2018-05-04 |
| 1407359151 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 9801 204th Ave E, Bonney Lake, WA 98391 | 2018-03-08 |
| 1992217152 | Rachel Renee Andringa | Massage Therapist | 19102 Wa-410, Bonney Lake, WA 98391 | 2017-10-27 |
| 1437679099 | Emily A. Hansen | Occupational Therapist | 12202 209th Ave Ct. E., Liberty Ridge Elementary School, Bonney Lake, WA 98391 | 2017-06-26 |
| 1245782986 | Advance Behavior Education Continuum, Inc | Behavioral Analyst | 2305 164th Ave Ct, Bonney Lake, WA 98391 | 2016-10-28 |
| 1619343191 | Lauren Christine Difolco | Specialist | 10920 199th Ave. Ct. E., Bonney Lake Hs, Bonney Lake, WA 98391 | 2015-08-19 |
| 1699018192 | Michael Nelson | Dentist | 2803 176th Ave East, Lake Tapps, WA 98391 | 2013-04-03 |
| 1700141066 | Jacqueline Nguyen | Pharmacist | 20025 State Route 410 E, Bonney Lake, WA 98391 | 2012-07-11 |
| 1265737860 | Braden Shingleton | Massage Therapist | 19102 Sr 410 E Suite A, Bonney Lake, WA 98391 | 2011-01-13 |
| Find all providers in zip 98391 | ||||
| Taxonomy Code | 2471C3402X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Radiography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508311366 | Ramanpreet Dhaliwal | Radiologic Technologist | 10615 Se 256th St, Ste 101, Kent, WA 98030-6809 | 2016-08-22 |
| 1013233782 | Scott A Yount | Radiologic Technologist | Msron Nine 2000 W Marine View Dr, Everett, WA 98207-0001 | 2010-04-20 |
| 1215160221 | Andrew John Leyva | Radiologic Technologist | 701 5th Ave Ste 213, Seattle, WA 98104-7033 | 2009-08-25 |
| 1679610356 | Russ K Reynolds | Radiologic Technologist | 220 25th St Ne, East Wenatchee, WA 98802-4097 | 2007-01-31 |
| 1255951661 | Genevieve Hill | Radiologic Technologist | 325 9th Ave, Seattle, WA 98104-2420 | 2020-04-26 |
| 1740800143 | Jennifer Kuang | Radiologic Technologist | 325 9th Ave, Seattle, WA 98104-2499 | 2020-04-26 |
| 1376163774 | Renee Jackson | Radiologic Technologist | 325 9th Ave, Seattle, WA 98104-2499 | 2020-04-26 |
| 1710312772 | Alma Miller | Radiologic Technologist | 1660 S Columbian Way, Seattle, WA 98108-1532 | 2013-09-10 |
| 1114060001 | Antoine Tahkeal | Radiologic Technologist | 401 Buster Rd, Toppenish, WA 98948-9792 | 2007-02-14 |
| 1811043706 | Valley Mobile X-ray, Inc. | Radiologic Technologist | 308 N 6th Ave, Yakima, WA 98902-2114 | 2007-01-25 |
| Find all providers with the same taxonomy | ||||
| City | BONNEY LAKE |
| Zip Code | 98391 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.