DR. BRUCE GARDNER MD NPI 1194815480

NPI Information

NPI: 1194815480
Provider Name: DR. BRUCE GARDNER, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
1915 QUEEN ANNE AVE N
SEATTLE, WA
ZIP 98109
Phone: (206) 284-6132
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DR. Bruce Gardner, MD is a family medicine in Seattle, WA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Bruce Gardner, MD NPI is 1194815480. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1915 QUEEN ANNE AVE N
SEATTLE, WA
ZIP 98109-549
Phone: (206) 284-6132
Fax: (206) 284-2566

The enumeration date for this NPI number is 10/15/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		MD00020877	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5350424	OTHER		AETNA
2	AB24834	MEDICARE ID-TYPE UNSPECIFIED	WASHINGTON	MEDICARE
3	A04528	MEDICARE UPIN	WASHINGTON
4	GA5004	OTHER	WASHINGTON	REGENCE BLUE SHIELD
5	8102048	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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