Individual
DR. EMMANUEL J. EUSEBIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
PEACEHEALTH MEDICAL GROUP, 4545 CORDATA PARKWAY, SUITE 1F, BELLINGHAM, WA 98226
(360) 738-2200
(360) 752-5679
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1462
(360) 729-3104
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
MD00030270
WA
208000000X
Pediatrics Physician
Primary
MD00030270
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083229
—
WA
Enumeration date
10/14/2005
Last updated
07/26/2019
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