Individual provider Active NPI

Bryan C. Dryer, MD

  • Pediatrics Physician
  • Bainbridge Island, WA
National Provider Identifier
1639136922
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60037735 Issued in WA
Practice address
945 Hildebrand LN NE Ste 100
Bainbridge Island, WA 98110
Phone
(206) 991-2121
Fax
(206) 991-2151
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1694 WI
Student in an Organized Health Care Education/Training Program 390200000X 49787 WI
Pediatrics Physician 208000000X MD60037735 WA Primary

Addresses

Primary practice location

945 Hildebrand LN NE Ste 100
Bainbridge Island, WA 98110

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608

Other identifiers 1

IdentifierTypeStateIssuer
1639136922MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101126000025 WA Practitioner - Pediatric Medicine 5496941825 Reassigns benefits to 2 organizations
I20220812001593 OR Practitioner - Pediatric Medicine 5496941825 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1694WIMDRegistered Dietitian
MD60037735WAMDPediatrics Physician
49787WIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Children'S Hospital Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Pediatrics CurrentSince May 9, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince May 9, 2022 Accepting new patients
Seattle Children'S Hospital CurrentSince Apr 8, 2014 Accepting new patients
Seattle Childrens Hospital CurrentSince Apr 8, 2014 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Pediatrics CurrentSince May 9, 2022 Accepting new patients
Children'S Hospital & Regional Medical Center 2 Past Accepting new patients

Locations

9800 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2457

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

34503 9th Ave S
Ste 300
Federal Way, WA 98003
Phone (253) 838-5878

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1639136922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 HILDEBRAND LN NE STE 100",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-991-2121",
            "fax_number": "206-991-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYER",
        "first_name": "BRYAN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "1694",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "49787",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60037735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639136922",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

Verify at the official NPI Registry.