Organization
EASTSIDE VASCULAR LLP
Active
Organization
EASTSIDE VASCULAR LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUDLEY MOORHEAD II MEDICAL DOCTOR (PARTNER)
(425) 450-7007
Entity
Organization
Contact information
Practice address
1135 116TH AVE NE STE 220, BELLEVUE, WA 98004-4623
(425) 450-7007
(425) 450-0026
Mailing address
1135 116TH AVE NE STE 220, BELLEVUE, WA 98004-4623
(425) 450-7007
(425) 450-0026
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1098326
—
WA
05
—
1371004
—
WA
01
—
CB3636
RAILROAD MEDICARE
—
Enumeration date
03/06/2007
Last updated
11/03/2009
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