Individual
DR. BRUCE M PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8097 HARBORVIEW RD, BLAINE, WA 98230-9639
(360) 371-5855
(360) 371-5857
Mailing address
709 W ORCHARD DR, SUITE 4, BELLINGHAM, WA 98225-1766
(360) 318-8800
(360) 318-1085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00014727
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0128920
LABOR & INDUSTRIES (REG)
WA
01
—
080147969
RAILROAD MEDICARE
WA
01
—
14509
REGENCE BLUESHIELD
WA
05
—
1722602
—
WA
01
—
423898002
GROUP HEALTH COOPERATIVE
WA
01
—
8924735
LABOR & INDUSTRIES (CV)
WA
Enumeration date
06/08/2006
Last updated
07/24/2012
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