Individual
DR. THEODORE ELLIOT BUSHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
325 9TH AVE, BOX 359803, SEATTLE, WA 98104-2420
(206) 731-4240
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD00043267
WA
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
MD00043267
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043375405
—
WA
Enumeration date
12/26/2006
Last updated
09/23/2014
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