Individual
ERIC DALE MAGNUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SIDPT
Contact information
Practice address
1305 SENECA ST, SEATTLE, WA 98101-2828
(206) 323-0934
Mailing address
4415 HOYT AVE APT 1, EVERETT, WA 98203-2348
(425) 268-6212
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CO60899549
WA
Other
Enumeration date
06/25/2020
Last updated
06/25/2020
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