Healthcare Provider Details

I. General information

NPI: 1821482571
Provider Name (Legal Business Name): MR. ESTEBAN ANTONIO DORIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVEN DORIA

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 MADISON ST
EVERETT WA
98203-4543
US

IV. Provider business mailing address

PO BOX 2569
EVERETT WA
98213-0569
US

V. Phone/Fax

Practice location:
  • Phone: 425-212-4200
  • Fax: 425-212-4220
Mailing address:
  • Phone: 425-212-4200
  • Fax: 425-212-4220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCG70005142
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: