Individual
JOHN F MATISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1330 ROCKEFELLER AVE, SUITE 225, EVERETT, WA 98201-1684
(425) 261-4910
(425) 261-4911
Mailing address
1330 ROCKEFELLER AVE, SUITE 225, EVERETT, WA 98201-1684
(425) 261-4910
(425) 261-4911
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10004886
WA
363AS0400X
Surgical Physician Assistant
PA10004886
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8435968
—
WA
Enumeration date
08/29/2005
Last updated
12/12/2007
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