# KUSAKABE PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891948840
- **Authorized official:** DR. PETER TSUYOSHI KUSAKABE DMD (PRESIDENT)
- **Authorized official phone:** (206) 324-2232

## Contact information

- **Practice address:** 1414 E YESLER WAY, SEATTLE, WA 98122-5508
- **Practice address phone:** (206) 324-2232
- **Practice address fax:** (206) 324-6006
- **Mailing address:** 1414 E YESLER WAY, SEATTLE, WA 98122-5508
- **Mailing address phone:** (206) 324-2232
- **Mailing address fax:** (206) 324-6006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2462 | WA | Yes |
| 1223G0001X | General Practice Dentistry | 6050 | WA | — |

## Other

- **Enumeration date:** 11/03/2008
- **Last updated:** 11/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5001813 | — | WA |