Individual
JASON DETTORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1500
Mailing address
11511 NE 10TH ST, BELLEVUE, WA 98004-8578
(425) 502-3000
(425) 502-3589
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60236693
WA
207W00000X
Ophthalmology Physician
Primary
MD60236693
WA
Other
Enumeration date
07/09/2008
Last updated
03/30/2021
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