Provider Demographics
NPI:1518731710
Name:KUSHNER AUBURN PLLC
Entity Type:Organization
Organization Name:KUSHNER AUBURN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUREVICH KUSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-779-7711
Mailing Address - Street 1:1380 112TH AVE NE STE 307
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3759
Mailing Address - Country:US
Mailing Address - Phone:253-236-5240
Mailing Address - Fax:866-861-6286
Practice Address - Street 1:1380 112TH AVE NE STE 307
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3759
Practice Address - Country:US
Practice Address - Phone:253-236-5240
Practice Address - Fax:866-861-6286
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KUSHNER AUBURN PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223X2210XDental ProvidersDentistOrofacial PainGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty