Bridge, Theodore Allen
Bridge, Theodore Allen is an sole proprietor health care provider with primary practice located at 1014 S 320Th St Suite C, Federal Way WA 98003-5344. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bridge, Theodore Allen can be contacted via phone (253) 941-0673.Contact Information
Primary practice address
1014 S 320Th St Suite C
Federal Way WA 98003-5344
Phone: (253) 941-0673
Fax: (253) 941-8109
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00029692 | Washington |
Profile Details
| NPI number | 1649375114 |
|---|---|
| LBN Legal business name | Bridge, Theodore Allen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1649375114 | NPPES |
| Washington | MEDICAID | 1079177 |
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