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:
Health care specialties
| Specialty | Code | License # | 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 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 | 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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