Individual
DR. JOHN LAWRENCE HEADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21600 HIGHWAY 99, #280, EDMONDS, WA 98026-8012
(425) 774-2616
(425) 774-2660
Mailing address
21600 HIGHWAY 99, #280, EDMONDS, WA 98026-8012
(425) 774-2616
(425) 774-2660
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD00018010
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030683
—
WA
Enumeration date
07/12/2006
Last updated
07/08/2007
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