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Individual

ROGER W BUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS M4-PA, SEATTLE, WA 98101-2756
(206) 583-6025
(206) 515-5886

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00019262
WA
208M00000X
Hospitalist Physician
Primary
MD00019262
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0030012
LABOR & INDUSTRY
WA
01
110195638
RAILROAD MEDICARE
05
8101636
WA
01
B868
BLUE SHIELD
WA
01
MD9262
ALASKA MEDICAID
WA
01
US0899731
AETNA/USHC PCP
WA
01
US4119874
AETNA/USHC SPECIALIST
WA
Enumeration date
07/02/2006
Last updated
05/04/2010
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