Healthcare Provider Details

I. General information

NPI: 1053969345
Provider Name (Legal Business Name): CYNTHIA VIRGINIA GARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 33RD ST
EVERETT WA
98201-4107
US

IV. Provider business mailing address

811 33RD ST
EVERETT WA
98201-4107
US

V. Phone/Fax

Practice location:
  • Phone: 425-923-8748
  • Fax:
Mailing address:
  • Phone: 425-923-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWI.LW.70001889
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: