Dr. Peter A Balousek
Neurosurgeon
4033 Talbot Rd S Ste 520
Renton
, Washington 98055-5772
Dr. Peter A Balousek
Neurosurgeon
4033 Talbot Rd S Ste 520
Renton
, Washington 98055-5772
(425) 690-2715
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About
Features
Specialties
- Neurosurgeon
Languages spoken
- English
Location
First Address
- Dr. Peter A Balousek
- 3600 Lind Ave Sw Suite 100 Attn Credentialing
- Renton, WA
- Zip : 98057-4970
- Phone : (425) 690-2715
Second Address
- Dr. Peter A Balousek
- 4033 Talbot Rd S Ste 520
- Renton, WA
- Zip : 98055-5772
- Fax : (425) 690-9586
- Phone : (425) 690-3586
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207T00000X | Neurosurgeon | MD00035044 | WA |
National Provider Identifier
| NPI | 1063407716 |
|---|---|
| Provider Name | Dr. Peter A Balousek |
| First Address | Renton, WA 98057-4970 |
| Second Address | Renton, WA 98055-5772 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/09/2005 |
| Last Update Date | 18/08/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1001438 | (05) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.