Healthcare Provider Details

I. General information

NPI: 1588858542
Provider Name (Legal Business Name): DR. DAWN MARIE CANTRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN M. MCNIEL

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3927 RUCKER AVE
EVERETT WA
98201-4833
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 425-259-0966
  • Fax:
Mailing address:
  • Phone: 206-860-5414
  • Fax: 206-720-8462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD60070851
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: