Provider Demographics
NPI:1083605901
Name:RASMUSSEN, ERIC DAVID (MD, MDM, FACP)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVID
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:MD, MDM, FACP
Other - Prefix:
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Mailing Address - Street 1:11221 CENTRAL VALLEY RD NW
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7013
Mailing Address - Country:US
Mailing Address - Phone:360-692-7972
Mailing Address - Fax:360-475-4825
Practice Address - Street 1:ONE BOONE ROAD
Practice Address - Street 2:DEPARTMENT OF MEDICINE, CODE 031, NAVAL HOSPITAL
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-1898
Practice Address - Country:US
Practice Address - Phone:360-475-4946
Practice Address - Fax:360-475-4825
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD44912207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD44912OtherSTATE LICENSE
WAMD44912OtherSTATE LICENSE