Healthcare Provider Details

I. General information

NPI: 1891754792
Provider Name (Legal Business Name): CRAIG M MCALLISTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21401 72ND AVE W
EDMONDS WA
98026
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 425-412-1875
  • Fax: 425-304-1103
Mailing address:
  • Phone: 425-412-1875
  • Fax: 425-304-1103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD00028073
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: