Healthcare Provider Details

I. General information

NPI: 1114031853
Provider Name (Legal Business Name): DAVID F PRATT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 COLBY AVE
EVERETT WA
98201-4989
US

IV. Provider business mailing address

4005 COLBY AVE
EVERETT WA
98201-4989
US

V. Phone/Fax

Practice location:
  • Phone: 425-258-3446
  • Fax: 425-252-7321
Mailing address:
  • Phone: 425-258-3446
  • Fax: 425-252-7321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberMD00036994
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMD00036994
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: