Provider Demographics
NPI:1083987861
Name:EVERETT, KAREN LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LEE
Last Name:EVERETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 171ST ST NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-6433
Mailing Address - Country:US
Mailing Address - Phone:360-658-7741
Mailing Address - Fax:360-658-7806
Practice Address - Street 1:3911 171ST ST NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-6433
Practice Address - Country:US
Practice Address - Phone:360-658-7741
Practice Address - Fax:360-658-7806
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000107821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice