Individual
DR. PETER A BALOUSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4033 TALBOT RD S, STE 520, RENTON, WA 98055-5772
(425) 690-3586
(425) 690-9586
Mailing address
3600 LIND AVE SW, SUITE 100 ATTN CREDENTIALING, RENTON, WA 98057-4970
(425) 690-2715
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD00035044
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001438
—
WA
Enumeration date
09/19/2005
Last updated
08/18/2021
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