Individual
EDYTH MICHELLE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 339-5422
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60748905
WA
363AM0700X
Medical Physician Assistant
1411
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2080657
—
WA
Enumeration date
06/28/2006
Last updated
03/17/2018
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