DR. BRENDAN JOHN MCCULLOUGH (NPI# 1497954317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497954317 |
| Entity Type | Individual |
| Full Name | DR. BRENDAN JOHN MCCULLOUGH |
| Credential | MD |
| Practice Address |
19020 33rd Ave W Ste 210 Lynnwood WA 98036-4748 |
| Practice Telephone | 4255631500 |
| Practice Fax Number | 4255631501 |
| Mailing Telephone | 4255631500 |
| Mailing Fax Number | 4255631374 |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2019-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
MEDS7777 | AK | Allopathic & Osteopathic Physicians |
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
M-12499 | ID | Allopathic & Osteopathic Physicians |
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
MD60106629 | WA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MEDS7777 | AK | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M-12499 | ID | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD60106629 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I-RADIA KING COUNTY | 0341836 | 01 |
| ID | 1497954317 | 05 | |
| WA | L&I-SEATTLE RADIOLOGY | 0404021 | 01 |
| WA | L&I-RADIA REST OF WA | 0317438 | 01 |
| WA | L&I-EVERGREEN RADIA | 0341845 | 01 |
| AK | 1613891 | 05 | |
| WA | L&I-SWEDISH RADIA EDMONDS | 0341837 | 01 |
| WA | 2018524 | 05 |
| Street Address |
19020 33RD AVE W STE 210 |
| City | LYNNWOOD |
| State | WA |
| Zip Code | 98036-4748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556868 | Prabhakar P. Kesava | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2005-05-31 |
| 1861869661 | Elysia Bethany Louise Andrews | Physician Assistant | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2015-08-27 |
| 1962805226 | Ryan A. Gilbreth | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2014-10-01 |
| 1154735561 | Harrison Patrick March | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2014-06-13 |
| 1881005833 | Yasmin Syeda Akbari | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2014-05-13 |
| 1225458839 | Nicholas Ryan Galloway | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2014-04-22 |
| 1639598873 | Bradley David Griffitts | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2014-04-15 |
| 1427476704 | Ryan Frederick Herde | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2014-04-03 |
| 1679991442 | Xi Zhang | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2014-03-31 |
| 1922432335 | Tamuna Chabra | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2013-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342630 | Zachary Perry | Behavior Technician | 4100 Veterans Way, Unit 100, Lynnwood, WA 98036 | 2020-10-08 |
| 1942832795 | Alexis Michelle Solomon-winne | Behavior Technician | 4100 Veterans Way Unit 100 Lynnwood, Wa 98036 United S, Lynnwood, WA 98036 | 2020-02-10 |
| 1881239028 | Endc Pllc | Psychologist | 19217 36th Ave W. Suite 219, Lynnwood, WA 98036 | 2019-11-12 |
| 1225507866 | Kyung Suk Seo | Massage Therapist | 18904 Hwy 99, Ste. K, Lynnwood, WA 98036 | 2018-11-13 |
| 1790270197 | Kabal Sriviboon | Behavior Technician | 20818 44th Ave W Suite 270, Lynnwood, WA 98036 | 2018-06-27 |
| 1992206148 | Kendal Ilyse Borison | Behavioral Analyst | 4100 194th Se, Suite 100, Lynnwood, WA 98036 | 2018-02-23 |
| 1205352515 | Doug Brant | Registered Nurse | 19931 Cypress Way, Lynnwood, WA 98036 | 2017-08-17 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1699213439 | Patrick J. Pacyga | Dentist | 19620 Wa-99, Suite 106, Lynnwood, WA 98036 | 2017-02-01 |
| 1134676646 | Fiona Green | Occupational Therapy Assistant | 21503 8th Place W, A, Lynnwood, WA 98036 | 2016-09-01 |
| Find all providers in zip 98036 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556868 | Prabhakar P. Kesava | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2005-05-31 |
| 1154735561 | Harrison Patrick March | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2014-06-13 |
| 1477812873 | Alfonso Ricardo Urdaneta-moncada | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2012-05-07 |
| 1780903773 | Hannu Tapio Huhdanpaa | Radiology | 19020 33rd Ave W, Suite 210, Lynnwood, WA 98036-4746 | 2010-05-31 |
| 1548590813 | Anne Marie Mclellan | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2010-01-07 |
| 1942466156 | Shaheen Ibrahim Umar | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2008-08-07 |
| 1497914691 | Samantha Chau Lancaster | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2008-06-03 |
| 1932300613 | William Bradley Jones | Radiology | 19020 33rd Ave W, Suite 210, Lynnwood, WA 98036-4746 | 2007-05-30 |
| 1982815296 | Kenneth John Hebert | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2007-05-25 |
| 1144364605 | Daniel Susanto | Radiology | 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 | 2007-02-17 |
| Find all providers in LYNNWOOD | ||||
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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.