Individual
MR. JOHN A COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1135 116TH AVE NE, BELLEVUE, WA 98004-4604
(425) 451-4141
(425) 451-4144
Mailing address
PO BOX 24503, SEATTLE, WA 98124-0503
(425) 451-4141
(425) 451-4144
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00032956
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135607
L & I INDIVIDUAL#
WA
05
—
8210528
—
WA
Enumeration date
06/14/2006
Last updated
07/09/2007
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