Healthcare Provider Details

I. General information

NPI: 1063074169
Provider Name (Legal Business Name): EUGENE SHCHYTOU ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 13TH ST STE 401
EVERETT WA
98201-1621
US

IV. Provider business mailing address

1717 13TH ST STE 401
EVERETT WA
98201-1621
US

V. Phone/Fax

Practice location:
  • Phone: 425-297-5660
  • Fax:
Mailing address:
  • Phone: 425-297-5660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60980836
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: