Johnsrude, Theodore Eugene

Johnsrude, Theodore Eugene is an individual health care provider with primary practice located at 9398 Ridgetop Blvd Nw , Silverdale WA 98383-8505. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Johnsrude, Theodore Eugene can be contacted via phone (360) 782-3200.

Contact Information

Primary practice address
9398 Ridgetop Blvd Nw Silverdale WA 98383-8505
Phone: (360) 782-3200
Fax: (360) 782-3245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD00019724 Washington

Profile Details

NPI number 1265484299
LBN Legal business name Johnsrude, Theodore Eugene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265484299 NPPES
Washington Other 75433 LABOR & INDUSTRIES
Washington MEDICAID 8316200 LABOR & INDUSTRIES
Washington Other 5358025 LABOR & INDUSTRIES
Washington Other JO4187 LABOR & INDUSTRIES

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