1699939009 NPI number — MARGARET FUCHS MITCHELL PHD

Table of content: MARGARET FUCHS MITCHELL PHD (NPI 1699939009)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699939009 NPI number — MARGARET FUCHS MITCHELL PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MITCHELL
Provider First Name:
MARGARET
Provider Middle Name:
FUCHS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699939009
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 HOYT AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVERETT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98201-4918
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-259-0966
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1728 W MARINE VIEW DR
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
EVERETT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98201-2094
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-339-5453
Provider Business Practice Location Address Fax Number:
425-252-4441
Provider Enumeration Date:
07/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PY00003912 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PY00003912 . This is a "LICENS NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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