Provider Demographics
NPI:1871745794
Name:HILL, BRYAN A SR (PSYD)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:A
Last Name:HILL
Suffix:SR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 SW 352ND CT
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-6944
Mailing Address - Country:US
Mailing Address - Phone:206-919-4193
Mailing Address - Fax:
Practice Address - Street 1:909 S 336TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7394
Practice Address - Country:US
Practice Address - Phone:253-235-5956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00059125101Y00000X
WAPY60275617103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor