Provider Demographics
NPI:1275515702
Name:STUHRING, GLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:GLEN
Middle Name:
Last Name:STUHRING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14048 JUANITA DR NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-9712
Mailing Address - Country:US
Mailing Address - Phone:425-899-5300
Mailing Address - Fax:425-899-5304
Practice Address - Street 1:14048 JUANITA DR NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-9712
Practice Address - Country:US
Practice Address - Phone:425-899-5300
Practice Address - Fax:425-899-5304
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0327683OtherLABOR & INDUSTRIES
WAP01345685OtherRAILROAD MEDICARE
WAP01345685OtherRAILROAD MEDICARE
WAA05733Medicare UPIN
WAG217120803Medicare PIN
WAG8896440Medicare PIN
WA080076959OtherMEDICARE RAILROAD