Individual
MAURICE VICTOR LUSTGARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27 100TH AVE NE, BELLEVUE, WA 98004
(425) 454-3135
(425) 451-8662
Mailing address
27 100TH AVE NE, BELLEVUE, WA 98004
(425) 454-3135
(425) 451-8662
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00011671
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523604
—
WA
Enumeration date
10/03/2006
Last updated
07/08/2007
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