National Provider Identifier Database

PRUDENCIO G TIBLE, MD – NPI #1679663884
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

PRUDENCIO G TIBLE, MD
5023 S BARTON PLACE
SEATTLE, WA98118
Phone: 206-725-8043
Fax: 206-760-1359
Website:
Specialty Taxonomy Code
* General Practice 208D00000X

* Indicates primary specialty

NPI Profile & details for PRUDENCIO G TIBLE

NPI Number 1679663884
Credentials MD
Entity Individual
Enumeration date 10/16/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 No
Identifiers
  • WA License #: MD00022189
  • WA Medicaid: 1035013
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for PRUDENCIO G TIBLE, MD

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