Individual
EBEN E TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4300
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD00042816
WA
207RI0011X
Interventional Cardiology Physician
MD00042816
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8371239
—
WA
01
—
P00071409
RAIL ROAD MEDICARE
WA
Enumeration date
03/19/2007
Last updated
10/29/2007
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