Provider Demographics
NPI:1467544460
Name:MOSBRUCKER, CYNTHIA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARIE
Last Name:MOSBRUCKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:MARIE
Other - Last Name:MOSBRUCKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11505 BURNHAM DRIVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332
Mailing Address - Country:US
Mailing Address - Phone:253-313-5997
Mailing Address - Fax:253-313-5197
Practice Address - Street 1:11505 BURNHAM DRIVE
Practice Address - Street 2:SUITE 302
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332
Practice Address - Country:US
Practice Address - Phone:253-313-5997
Practice Address - Fax:253-313-5197
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60016675207VG0400X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C09578Medicare UPIN
HI00051302Medicare ID - Type Unspecified