Organization
QUEEN ANNE FAMILY MEDICINE INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE GARDNER MD (OWNER)
(206) 284-6132
Entity
Organization
Contact information
Practice address
1915 QUEEN ANNE AVE N, SEATTLE, WA 98109-2549
(206) 284-6132
(206) 284-2566
Mailing address
1915 QUEEN ANNE AVE N, SEATTLE, WA 98109-2549
(206) 284-6132
(206) 284-2566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7108426
—
WA
Enumeration date
10/15/2006
Last updated
06/21/2018
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