| NPI | 1033279831 |
|---|---|
| Former Name | ADDIE BUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10003324) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10003324) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2023-07-13 |