Organization
EVERETT HERITAGE COURT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM BROWN (PRESIDENT)
(425) 259-7200
Entity
Organization
Contact information
Practice address
4230 COLBY AVE, EVERETT, WA 98203-2312
(425) 259-7200
(425) 339-9089
Mailing address
4230 COLBY AVE, EVERETT, WA 98203-2312
(425) 259-7200
(425) 339-9089
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
601 689 162
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
798861
—
WA
Enumeration date
06/18/2008
Last updated
06/18/2008
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