Individual
JUSTIN LAMONT BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2420
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD61462284
WA
207RN0300X
Nephrology Physician
Primary
MD61462284
WA
Other
Enumeration date
03/21/2019
Last updated
07/24/2024
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