Individual
MITCHELL WILLIAM HUSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 NW MARKET ST STE 207, SEATTLE, WA 98107-3909
(206) 320-7288
(206) 320-7289
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD61190294
WA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
MD61190294
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165846
—
WA
Enumeration date
03/20/2019
Last updated
10/05/2023
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