THEODORE EUGENE JOHNSRUDE M.D. NPI 1265484299

NPI Information

  • NPI: 1265484299
  • Provider Name: THEODORE EUGENE JOHNSRUDE, M.D.
  • Classification: Urology - 208800000X
  • Entity Type: Individual
  • Address: 9398 RIDGETOP BLVD NW
    SILVERDALE, WA
    ZIP 98383
  • Phone: (360) 782-3200

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NPI Details

Theodore Eugene Johnsrude, M.D. is an urology in Silverdale, WA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. Theodore Eugene Johnsrude, M.D. NPI is 1265484299. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9398 RIDGETOP BLVD NW
SILVERDALE, WA
ZIP 98383-505
Phone: (360) 782-3200
Fax: (360) 782-3245

The enumeration date for this NPI number is 5/17/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyMD00019724WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
175433OTHERWASHINGTONLABOR & INDUSTRIES
28316200MEDICAIDWASHINGTON
35358025OTHERAETNA
4JO4187OTHERREGENCE BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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