Healthcare Provider Details

I. General information

NPI: 1992751689
Provider Name (Legal Business Name): WILLIAM J GALLAGHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 02/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 NORTON AVE SUITE 202
EVERETT WA
98201-4290
US

IV. Provider business mailing address

PO BOX 3360
PORTLAND OR
97208-3360
US

V. Phone/Fax

Practice location:
  • Phone: 425-297-5330
  • Fax:
Mailing address:
  • Phone: 866-366-2983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD00027708
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: