Healthcare Provider Details

I. General information

NPI: 1629735618
Provider Name (Legal Business Name): EZZIA HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2021
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9802 EVERGREEN WAY
EVERETT WA
98204-3828
US

IV. Provider business mailing address

9802 EVERGREEN WAY
EVERETT WA
98204-3828
US

V. Phone/Fax

Practice location:
  • Phone: 781-775-9026
  • Fax:
Mailing address:
  • Phone: 425-610-3171
  • Fax: 866-502-3611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PHYLIS MUTHEE
Title or Position: OWNER
Credential: APRN
Phone: 781-775-9026