Unknown Individual – Family Medicine Physician, NPI 1184654139
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
909, Broadway, Glendale, Everett, Middlesex County, Massachusetts, 02149, United States
PBO/CREDENTIALING
EVERETT, WA 982011409
Phone: (425) 317-0246
Fax: (425) 317-0291
Type: Mailing
Harbour Pointe Boulevard Southwest, Mukilteo, Snohomish County, Washington, 98275, United States
SUITE 100
MUKILTEO, WA 982755457
Phone: (425) 347-6330
Fax: (425) 347-6335
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98201)
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