Providence Physician Group in Everett - Procedural Dermatology
Providence Physician Group - NPI 1932270360
Providence Physician Group is a Procedural Dermatology in Everett, Washington. Providence Physician Group practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Providence Physician Group is 1932270360. The last update date is 2020-08-22.
Providence Physician Group's current location address is 12800 Bothell Everett Hwy, Everett, Washington. You can contact this provider via phone number 4253165080 and fax number 4253165025. The mailing address for Providence Physician Group is 12800 Bothell Everett Hwy, Everett, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Providence Physician Group |
|---|---|
| Address | 12800 Bothell Everett Hwy, Everett, Washington |
| Phone Number | 4253165080 |
| Fax Number | 4253165025 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CHIEF EXEC |
|---|---|
| Authorized Official Name | Beegle D. Earl |
| Credentials | MD |
| Telephone Number | 4253165470 |
NPI Number Detail
| NPI Number | 1932270360 |
|---|---|
| Provider Enumeration Date | 2006-11-09 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 12800 Bothell Everett Hwy |
|---|---|
| City | Everett |
| State | Washington (WA) |
| Post Code | 982086642 |
| Phone Number | 4253165080 |
| Fax Number | 4253165025 |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
|
Definition: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surge |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7114101 | WA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Providence Physician Group?
The Providence Physician Group has been issued the NPI (National Provider Identifier) 1932270360 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Providence Physician Group located?
The Providence Physician Group is located at 12800 Bothell Everett Hwy, Everett, WA 982086642.
What is Providence Physician Group's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Providence Physician Group is Procedural Dermatology, and the taxonomy code that categorizes this field of expertise is 207Ns0135X.
When did Providence Physician Group receive its 1932270360 assignment?
The Providence Physician Group was assigned its 1932270360 on 2006-11-09, which is the date when this unique identifier was issued to the organization.
When was the information related to Providence Physician Group most recently updated or refreshed?
The details pertaining to the Providence Physician Group, including its address, specialty, and other relevant information, were last updated or refreshed on 2020-08-22.