Individual
JOHN C LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1321 COLBY AVE, EVERETT, WA 98201-1665
(360) 658-4339
Mailing address
1301 W FLETCHER ST APT 305, CHICAGO, IL 60657-3251
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD00046492
WA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
MD00046492
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0211679
DEPT OF L&I
WA
01
—
A093
CHAMPUS/TRICARE
WA
Enumeration date
09/21/2006
Last updated
04/29/2010
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