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Individual

SETH BRUINSMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
10002 SE 240TH ST, KENT, WA 98031-4839
(253) 852-2020
(253) 854-2020
Mailing address
10002 SE 240TH ST, KENT, WA 98031-4839
(253) 852-2020
(253) 854-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00004151
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0292254
LABOR & INDUSTRIES
WA
01
0992BR
REGENCE
WA
01
0993BR
REGENCE
WA
01
0994BR
REGENCE
WA
01
1091BR
REGENCE
WA
05
2016991
WA
Enumeration date
07/18/2007
Last updated
05/30/2012
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