DR. INDRAWAN HUSODO (NPI# 1376541847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376541847 |
| Entity Type | Individual |
| Full Name | DR. INDRAWAN HUSODO |
| Credential | M.D. |
| Practice Address |
990 Sylvan Way Bremerton WA 98310-2851 |
| Practice Telephone | 3604793657 |
| Practice Fax Number | 3603737616 |
| Mailing Telephone | 3604793657 |
| Mailing Fax Number | 3603737616 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2009-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | MD00028376 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | REGENCE BLUE SHIELD | HU0090 | 01 |
| WA | RAILROAD MEDCIARE | 050042796 | 01 |
| WA | 8132292 | 05 | |
| WA | GROUP HEALTH CORP | 06487001 | 01 |
| WA | LABOR AND INDUSTRIES | 72669 | 01 |
| WA | VICTIMS OF CRIME | 8933482 | 01 |
| WA | PREMERA BLUE CROSS | 910847215 | 01 |
| WA | KPS | 91084721521 | 01 |
| Street Address |
990 SYLVAN WAY |
| City | BREMERTON |
| State | WA |
| Zip Code | 98310-2851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447258926 | Timothy John Harpur | Anesthesiology | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2005-07-08 |
| 1952813297 | Michael Rein Ise Jr. | Registered Nurse | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2017-10-26 |
| 1245631290 | Emilee Ashby | Registered Nurse | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2014-09-09 |
| 1649573056 | Gustavo Pena | Nurse Anesthetist, Certified Registered | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2010-12-08 |
| 1013232842 | Henry Nguyen | Anesthesiology | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2010-04-05 |
| 1760706725 | Oscar Esteban Montes | Anesthesiology | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2010-03-19 |
| 1548597230 | Pamela Louise Kaman | Registered Nurse | 990 Sylvan Way, Ste 101, Bremerton, WA 98310-2851 | 2009-11-17 |
| 1417199324 | Theresa Mary Raleigh | Nurse Anesthetist, Certified Registered | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2009-03-24 |
| 1588855571 | Elizabeth D Benecki | Nurse Anesthetist, Certified Registered | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2007-08-06 |
| 1053477000 | Nancy D Briller | Anesthesiology | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2006-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891333613 | Miss Mary Community Development | Voluntary or Charitable | 1630 Trenton Avenue Apt 10, Bremerton, WA 98310 | 2019-12-11 |
| 1629636055 | Puget Sound Work Injury Clinic, LLC | Clinic/Center | 812 Cherry Ct, Bremerton, WA 98310 | 2019-05-31 |
| 1538672530 | Rachel E Mittelstaedt Parsons | Dietitian, Registered | 3059 Viewcrest Dr Ne, Bremerton, WA 98310 | 2017-11-13 |
| 1356888937 | Sarah Hike | Community Health Worker | 900 Sheridan, Bremerton, WA 98310 | 2017-01-20 |
| 1073941142 | Hana Singer | Physical Therapy Assistant | 3600 Forest Dr Ne, Bremerton, WA 98310 | 2013-10-28 |
| 1447508122 | Kevin Lee Hathaway | Mechanotherapist | 3308 Veska Avenue, Bremerton, WA 98310 | 2012-08-28 |
| 1003163007 | James Hyun Soo Lee | Surgery | Cvn 76 Uss Ronald Reagan, Bremerton, WA 98310 | 2012-08-08 |
| 1487936241 | Karen S Casseday | Nurse Practitioner | 1740 Ne Riddell Rd Ste 110, Bremerton, WA 98310 | 2011-09-16 |
| 1740560572 | Lauren P Foresman | Physician Assistant | 2709 Hemlock Street, Bremerton, WA 98310 | 2011-08-24 |
| 1538390059 | Patricia L Rushon | Speech-Language Pathologist | 560 Lebo Blvd., Bremerton, WA 98310 | 2009-07-31 |
| Find all providers in zip 98310 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629239686 | Jonathan Paul Miller | Anesthesiology | 5682 Londonderry Loop Nw, Bremerton, WA 98312-1188 | 2008-06-23 |
| 1932115789 | Rapin Chai Kanithanon | Anesthesiology | 2771 Hemlock St Ste 100, Bremerton, WA 98310-2689 | 2006-08-01 |
| 1578554531 | Mark Terry Pickett | Anesthesiology | Naval Hospital Bremerton, Boone Rd., Bremerton, WA 98312-1898 | 2005-10-31 |
| 1447258926 | Timothy John Harpur | Anesthesiology | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2005-07-08 |
| 1922006451 | Francisco Delacruz-newlan | Anesthesiology | 1010 Sylvan Way, Bremerton, WA 98310-2826 | 2005-07-08 |
| 1780114850 | Lisa Marie O'driscoll | Anesthesiology | 1 Boone Rd, Bremerton, WA 98312-1894 | 2017-06-12 |
| 1457700098 | Justin Norvell | Anesthesiology | 1 Boone Rd, Bremerton, WA 98312-1898 | 2016-06-05 |
| 1750693099 | Jeffrey Michael Carness | Anesthesiology | 1 Boone Rd, Bremerton, WA 98312 | 2010-07-01 |
| 1013232842 | Henry Nguyen | Anesthesiology | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2010-04-05 |
| 1760706725 | Oscar Esteban Montes | Anesthesiology | 990 Sylvan Way, Bremerton, WA 98310-2851 | 2010-03-19 |
| Find all providers in BREMERTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.