Individual
DR. JEFFERY EDWARD FITZTHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
549 MAIN ST, EDMONDS, WA 98020-3149
(425) 967-6974
(425) 967-5480
Mailing address
549 MAIN ST, EDMONDS, WA 98020-3149
(425) 967-6974
(425) 967-5480
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH00034708
WA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD00038676
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8254245
—
WA
Enumeration date
07/07/2006
Last updated
03/24/2016
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