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General NPI Number Information
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NPI Number | 1376526640
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Entity Type | Individual
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Provider Name | ANDRIUS P SKUCAS MD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12040 NE 128TH ST #69, EVERGREEN MEDICAL CENTER
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City | KIRKLAND
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State | WA
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Zip | 98034-3013
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Country | US
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Telephone | 425-899-3455
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Fax |
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Provider Business Mailing Address
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Address Line | 5733 26TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98105-5505
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Country | US
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Telephone | 206-527-5963
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD00039982
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License Number State | WA
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