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NPI Code Detail

MEDICARE: PUBLIC HOSPITAL DISTRICT #3 SNOHOMISH COUNTY

MEDICARE: PUBLIC HOSPITAL DISTRICT #3 SNOHOMISH COUNTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598704769
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUBLIC HOSPITAL DISTRICT #3 SNOHOMISH COUNTY
Provider Business Mailing Address
First Line : 330 S STILLAGUAMISH AVE
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-1642
Country : US
Telephone Number : 360-435-2133
Fax Number : 360-435-0513
Provider Business Practice Location Address
First Line : 16410 SMOKEY POINT BLVD
Second Line :
City : ARLINGTON
State : WA
Zip : 98223-8415
Country : US
Telephone Number : 360-653-4569
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : WILLIS CLARK JONES
Credential :
Telephone Number : 360-435-2133
Provider Enumeration Date : 06/05/2006
Last Update Date : 10/24/2007

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1063521888 — ALAN D ERICKSON D.D.S.
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Directions to “PUBLIC HOSPITAL DISTRICT #3 SNOHOMISH COUNTY ” Practice Location

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