Healthcare Provider Details

I. General information

NPI: 1164021077
Provider Name (Legal Business Name): GPC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 E GREEN LAKE WAY N STE 200
SEATTLE WA
98115-5491
US

IV. Provider business mailing address

6800 E GREEN LAKE WAY N STE 200
SEATTLE WA
98115-5491
US

V. Phone/Fax

Practice location:
  • Phone: 206-524-5656
  • Fax: 206-524-2841
Mailing address:
  • Phone: 206-524-5656
  • Fax: 206-524-2841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NAOMI BUSCH
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 206-914-6116