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General NPI Number Information
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NPI Number | 1528266103
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Entity Type | Organization
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Legal Business Name | EVERETT CARDIOLOGY & ELECTROPHYSIOLOGY, P.S.
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 1330 ROCKEFELLER AVE 225
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City | EVERETT
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State | WA
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Zip | 98201-1684
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Country | US
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Telephone | 425-261-4910
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Fax | 425-261-4911
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Provider Business Mailing Address
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Address Line | 1330 ROCKEFELLER AVE 225
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City | EVERETT
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State | WA
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Zip | 98201-1684
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Country | US
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Telephone | 425-261-4910
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Fax | 425-261-4911
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Authorized Official
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Title or Position | PHYSICIAN, PART OWNER
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Name | DR. JEFFREY STEVEN ROSE
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Credential | M.D.
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Telephone | 425-261-4910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | MD00022810
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | PA10004886
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | PA10004886
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD00022810
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | PA10004886
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD00022810
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License Number State | WA
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