Individual
MR. DWIGHT FRANCES BUSHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
4422 6TH AVE SE, LACEY, WA 98503-1020
(360) 704-7170
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
AP30001162
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9607375
—
WA
Enumeration date
10/19/2006
Last updated
09/11/2007
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