Individual
JACK MILLER BATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1410 BROADWAY, EVERETT, WA 98201-1720
(425) 789-2000
Mailing address
514 146TH ST SW, LYNNWOOD, WA 98087-6716
(425) 745-3636
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00024041
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023183
—
WA
Enumeration date
12/21/2006
Last updated
09/29/2009
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