| Ezzia Healthcare PLLC | |
|
9802 Evergreen Way Everett WA 98204-3828 | |
| (781) 775-9026 | |
| Not Available |
| Full Name | Ezzia Healthcare PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 9802 Evergreen Way, Everett, Washington |
| Authorized Official Name and Position | Phylis Muthee (OWNER) |
| Authorized Official Contact | 7817759026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ezzia Healthcare PLLC 9802 Evergreen Way Everett WA 98204-3828 Ph: (425) 610-3171 | Ezzia Healthcare PLLC 9802 Evergreen Way Everett WA 98204-3828 Ph: (781) 775-9026 |
| NPI Number | 1629735618 |
|---|---|
| Provider Enumeration Date | 11/24/2021 |
| Last Update Date | 11/22/2023 |
| Certification Date | 11/22/2023 |
| Medicare PECOS PAC ID | 9931590007 |
|---|---|
| Medicare Enrollment ID | O20211228000858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629735618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| Provider Name | Phylis Muthee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598015919 PECOS PAC ID: 3375760978 Enrollment ID: I20220119000497 |
| Provider Name | Janet Oladipo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053073114 PECOS PAC ID: 9032505177 Enrollment ID: I20220329002971 |
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