Individual
JUDE GERARD D VERZOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3021 GRIFFIN AVE, ENUMCLAW, WA 98022-2369
(360) 825-6511
(253) 274-7993
Mailing address
3021 GRIFFIN AVE, ENUMCLAW, WA 98022-2369
(360) 825-6511
(253) 274-7993
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00042893
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184016
STATE L&I
WA
01
—
0194113
STATE L&I
WA
05
—
1045610
—
WA
01
—
8904491
STATE CRIME VICTIMS
WA
01
—
8939176
STATE CRIME VICTIMS
WA
01
—
P00143183
MEDICARE RAILROAD
WA
Enumeration date
07/31/2006
Last updated
01/18/2021
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