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General NPI Number Information
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NPI Number | 1922857630
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Entity Type | Organization
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Legal Business Name | JONATHAN EVERETT DDS PLLC
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 115 S 177TH PL STE 101
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City | BURIEN
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State | WA
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Zip | 98148-1715
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Country | US
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Telephone | 206-242-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 115 S 177TH PL
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City | BURIEN
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State | WA
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Zip | 98148-1715
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Country | US
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Telephone | 206-242-1500
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Fax | 206-246-1565
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JONATHAN EVERETT
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Credential | DDS
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Telephone | 206-242-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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