Provider Demographics
NPI:1477648269
Name:NUETZMANN, JOHN STEVEN (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEVEN
Last Name:NUETZMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2536
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98227-2536
Mailing Address - Country:US
Mailing Address - Phone:360-738-7988
Mailing Address - Fax:360-738-4072
Practice Address - Street 1:12 BELLWETHER WAY
Practice Address - Street 2:SUITE 230
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2959
Practice Address - Country:US
Practice Address - Phone:360-738-7988
Practice Address - Fax:360-738-4072
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2011-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAOP00001612207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1124320Medicaid