Prudden, George A
Prudden, George A is an individual health care provider with primary practice located at 7308 Bridgeport Way W Suite 201, Lakewood WA 98499-8000. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Prudden, George A can be contacted via phone (253) 582-7257.Contact Information
Primary practice address
7308 Bridgeport Way W Suite 201
Lakewood WA 98499-8000
Phone: (253) 582-7257
Fax: (253) 582-1617
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA10004097 | Washington |
Profile Details
| NPI number | 1356310064 |
|---|---|
| LBN Legal business name | Prudden, George A |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2006 |
| Last updated | Oct 1st, 2019 - about 5 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356310064 | NPPES |
| Washington | Other | 6882PR | REGENCE BLUE SHIELD RIDER |
| Washington | MEDICAID | 8348963 | REGENCE BLUE SHIELD RIDER |
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