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Individual
DR. CARL JAY BODENSTEIN
Active
Individual
DR. CARL JAY BODENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD00020651
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000108137
—
MT
05
—
000038801
—
ID
01
—
10004603
REGENCE BLUE S. OF IDAHO
WA
05
—
205997
—
OR
01
—
5404342
AETNA
WA
05
—
8458507
—
WA
01
—
911922781
PHCO
WA
05
—
911922781
—
WA
01
—
BO6528
ASURIS NW HEALTH
WA
01
—
KA345
BLUE CROSS OF IDAHO
WA
Enumeration date
02/08/2006
Last updated
12/21/2009
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