Provider Demographics
NPI:1548460900
Name:DAVID MUSNICK, MD
Entity type:Organization
Organization Name:DAVID MUSNICK, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:MUSNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-452-7325
Mailing Address - Street 1:1300 114TH AVE SE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6942
Mailing Address - Country:US
Mailing Address - Phone:425-462-7325
Mailing Address - Fax:
Practice Address - Street 1:1300 114TH AVE SE
Practice Address - Street 2:SUITE 105
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6942
Practice Address - Country:US
Practice Address - Phone:425-462-7325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025616174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty