Healthcare Provider Details

I. General information

NPI: 1962667485
Provider Name (Legal Business Name): RICARDO CARDONA GUARACHE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RICARDO CARDONA

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 HOYT AVE
EVERETT WA
98201
US

IV. Provider business mailing address

7600 EVERGREEN WAY
EVERETT WA
98203-6421
US

V. Phone/Fax

Practice location:
  • Phone: 425-339-5411
  • Fax: 425-339-5448
Mailing address:
  • Phone: 206-860-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA145825
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number246854
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD60954575
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: