Individual
MINOO BALA D'CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1401 MADISON ST STE 100, SEATTLE, WA 98104-1316
(206) 386-6111
(206) 386-6113
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60942271
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750731782
—
WA
05
—
2136600
—
WA
Enumeration date
06/21/2016
Last updated
05/24/2023
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