Individual
DEDRA S BUCHWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2499
(206) 744-4192
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00024398
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110222363
RAIL ROAD MEDICARE
WA
01
—
7489
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
11/25/2013
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