Individual
DR. JOHN WESLEY LITTLE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1374
Mailing address
19020 33RD AVE W, SUITE 210, LYNNWOOD, WA 98036-4746
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M-12308
ID
2085R0202X
Diagnostic Radiology Physician
Primary
MD00018446
WA
2085R0202X
Diagnostic Radiology Physician
S-6158
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115851
L&I PROVIDER NUMBER
WA
05
—
1417935354
—
ID
01
—
155477
L&I PROVIDER NUMBER
WA
05
—
1584948
—
AK
01
—
175558
L&I PROVIDER NUMBER
WA
01
—
204110
L & I PROVIDER NUMBER
WA
05
—
8270407
—
WA
Enumeration date
01/01/2006
Last updated
02/06/2015
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