Individual
DR. BRUCE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1915 QUEEN ANNE AVE N, SEATTLE, WA 98109-2549
(206) 284-6132
(206) 284-2566
Mailing address
1915 QUEEN ANNE AVE N, SEATTLE, WA 98109-2549
(206) 284-6132
(206) 284-2566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00020877
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5350424
AETNA
—
05
—
8102048
—
WA
01
—
GA5004
REGENCE BLUE SHIELD
WA
Enumeration date
10/15/2006
Last updated
07/09/2007
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