Healthcare Provider Details

I. General information

NPI: 1861863441
Provider Name (Legal Business Name): MARCEL D BUDICA P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 NORTHUP WAY UW MEDICINE EASTSIDE SPECIALTY CENTER
BELLEVUE WA
98004-1467
US

IV. Provider business mailing address

325 9TH AVE HARBORVIEW MEDICAL CENTER, PO BOX 359750
SEATTLE WA
98104-2420
US

V. Phone/Fax

Practice location:
  • Phone: 877-520-5000
  • Fax: 206-598-6797
Mailing address:
  • Phone: 206-744-9888
  • Fax: 206-744-9773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: