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Individual

JEFFREY MICHAEL KRUSNIAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3015 SQUALICUM PKWY, STE 200, BELLINGHAM, WA 98225-1945
(360) 733-2092
(360) 788-6042
Mailing address
1115 SE 164TH AVE, DEPT 358, VANCOUVER, WA 98683-9324
(360) 733-2092
(360) 788-6042

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
5101013559
MI
207X00000X
Orthopaedic Surgery Physician
Primary
OP60390976
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200H310170
BCBSM GROUP ID NUMBER
MI
05
4742268
MI
01
JK013559
BCBS ID NUMBER
MI
Enumeration date
07/21/2006
Last updated
11/17/2014
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