Healthcare Provider Details

I. General information

NPI: 1225347115
Provider Name (Legal Business Name): MAGALY PILAR BAILON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAGALY PILAR HUAROTTE ARNP

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 HOYT AVE
EVERETT WA
98201-4988
US

IV. Provider business mailing address

PO BOX 5127
EVERETT WA
98206-5127
US

V. Phone/Fax

Practice location:
  • Phone: 425-317-3944
  • Fax: 425-317-3931
Mailing address:
  • Phone: 425-339-5408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN60331966
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number774188
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60368984
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: