| Wwmg Dept Of Neurology | |
|
12728 19th Ave Se Suite 300 Everett WA 98208-6526 | |
| (425) 259-4041 | |
| Not Available |
| Full Name | Wwmg Dept Of Neurology |
|---|---|
| Speciality | Psychiatry & Neurology - Neurocritical Care |
| Location | 12728 19th Ave Se, Everett, Washington |
| Authorized Official Name and Position | Elizabeth Bae (CONTRACT ANALYST/CREDENTIALING COOR) |
| Authorized Official Contact | 4252594041 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wwmg Dept Of Neurology 1728 W Marine View Dr Suite 110 Everett WA 98201-2094 Ph: (425) 259-4041 | Wwmg Dept Of Neurology 12728 19th Ave Se Suite 300 Everett WA 98208-6526 Ph: (425) 259-4041 |
| NPI Number | 1568916682 |
|---|---|
| Provider Enumeration Date | 08/05/2016 |
| Last Update Date | 06/19/2024 |
| Certification Date | 06/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568916682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A2900X | Psychiatry & Neurology - Neurocritical Care | (* (Not Available)) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
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