Provider Demographics
NPI:1093788820
Name:RADUEGE, JOHN W (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:RADUEGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE #4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:2075 BARKLEY BLVD
Practice Address - Street 2:SUITE #105
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6614
Practice Address - Country:US
Practice Address - Phone:360-671-3345
Practice Address - Fax:360-650-1354
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2009-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60076508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0248815OtherL&I
8951727OtherL&I CRIME VICTIMS
WI32405400Medicaid
WA8542946Medicaid
WA6339RAOtherREGENCE
8951727OtherL&I CRIME VICTIMS
WA0248815OtherL&I
WI68580Medicare ID - Type Unspecified