Cudahy, Bruce Gerald
Cudahy, Bruce Gerald is an individual health care provider with primary practice located at 9801 204Th Ave E , Bonney Lake WA 98391-6559. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cudahy, Bruce Gerald can be contacted via phone (253) 750-8135.Contact Information
Primary practice address
9801 204Th Ave E
Bonney Lake WA 98391-6559
Phone: (253) 750-8135
Fax: (253) 750-8136
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1641 | Washington |
Profile Details
| NPI number | 1457321135 |
|---|---|
| LBN Legal business name | Cudahy, Bruce Gerald |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Jan 19th, 2023 - about 3 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 | 1457321135 | NPPES |
| Washington | MEDICAID | 2001360 |
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