Provider Demographics
NPI:1609427566
Name:GLEN T STUHRING MD
Entity Type:Organization
Organization Name:GLEN T STUHRING MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:STUHRING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-599-0919
Mailing Address - Street 1:22309 OLD POPLAR WAY
Mailing Address - Street 2:
Mailing Address - City:BRIER
Mailing Address - State:WA
Mailing Address - Zip Code:98036-8138
Mailing Address - Country:US
Mailing Address - Phone:425-678-6954
Mailing Address - Fax:
Practice Address - Street 1:1507 NE 150TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-7221
Practice Address - Country:US
Practice Address - Phone:206-363-5353
Practice Address - Fax:206-363-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care