Organization
KUSAKABE PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER TSUYOSHI KUSAKABE DMD (PRESIDENT)
(206) 324-2232
Entity
Organization
Contact information
Practice address
1414 E YESLER WAY, SEATTLE, WA 98122-5508
(206) 324-2232
(206) 324-6006
Mailing address
1414 E YESLER WAY, SEATTLE, WA 98122-5508
(206) 324-2232
(206) 324-6006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2462
WA
1223G0001X
General Practice Dentistry
6050
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5001813
—
WA
Enumeration date
11/03/2008
Last updated
11/03/2008
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