Individual
DR. ROXANNE E HERTZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 PACIFIC AVE, SUITE 100, EVERETT, WA 98201-4261
(206) 244-1212
(206) 244-1223
Mailing address
PO BOX 5908, BELLEVUE, WA 98006-0408
(206) 244-1212
(206) 244-1223
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00032736
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184996
DEPT OF LABOR & INDUSTRIE
WA
01
—
4682HE
REGENCE BLUE SHIELD
WA
05
—
8017535
—
WA
01
—
8938073
CRIME VICTIMS PROGRAM
WA
Enumeration date
10/28/2005
Last updated
06/16/2008
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