| Kusakabe Professional Corporation | |
|
1414 E Yesler Way Seattle WA 98122-5508 | |
| (206) 324-2232 | |
| (206) 324-6006 |
| Full Name | Kusakabe Professional Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1414 E Yesler Way, Seattle, Washington |
| Authorized Official Name and Position | Peter Tsuyoshi Kusakabe (PRESIDENT) |
| Authorized Official Contact | 2063242232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kusakabe Professional Corporation 1414 E Yesler Way Seattle WA 98122-5508 Ph: (206) 324-2232 | Kusakabe Professional Corporation 1414 E Yesler Way Seattle WA 98122-5508 Ph: (206) 324-2232 |
| NPI Number | 1891948840 |
|---|---|
| Provider Enumeration Date | 11/03/2008 |
| Last Update Date | 11/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891948840 | NPI | - | NPPES |
| 5001813 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6050 (Washington) | Secondary |
| 1223G0001X | Dentist - General Practice | 2462 (Washington) | Primary |
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