MEDICARE: JOHN BROUSSARD PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1891626784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN BROUSSARD PHD

Provider Business Mailing Address
First Line	:	PO BOX 50095
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98145-5095
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-0001
Country	:	US
Telephone Number	:	206-520-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

Similar Medicare Providers

1780060137 — CHRISTINE BALDO RAYEL ARNP
Practice Location Address:

1959 NE PACIFIC ST
SEATTLE, WA
98195-0001

Practice Phone: 206-598-4333
Practice Fax:

1861134801 — DR. YESENIA ARELI WESTRUP MD
Practice Location Address:

1959 NE PACIFIC ST # 356540
SEATTLE, WA
98195-0001

Practice Phone: 323-336-1071
Practice Fax:

1083413272 — KATHLEEN SUZANN BOTTERBUSH
Practice Location Address:

1959 NE PACIFIC ST
SEATTLE, WA
98195-0001

Practice Phone: 206-543-3687
Practice Fax:

1801977038 — CHRISTOPHER S KIM MD
Practice Location Address:

1959 NE PACIFIC ST
SEATTLE, WA
98195-0001

Practice Phone: 206-698-4333
Practice Fax:

1669301420 — TESLA CROUSE
Practice Location Address:

1959 NE PACIFIC ST MAIN HOSPITAL
SEATTLE, WA
98195-0001

Practice Phone: 206-598-3300
Practice Fax:

1013847128 — YANG HE PHARMD, BCCP
Practice Location Address:

1959 NE PACIFIC ST
SEATTLE, WA
98195-0001

Practice Phone: 206-598-4176
Practice Fax: 206-598-7058

Directions to “ JOHN BROUSSARD PHD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.