Provider Demographics
NPI:1568055135
Name:EVERETT ACCIDENT & INJURY CLINIC
Entity Type:Organization
Organization Name:EVERETT ACCIDENT & INJURY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-512-8044
Mailing Address - Street 1:205 E CASINO RD STE B7
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2600
Mailing Address - Country:US
Mailing Address - Phone:425-374-8014
Mailing Address - Fax:425-903-4361
Practice Address - Street 1:205 E CASINO RD STE B7
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2600
Practice Address - Country:US
Practice Address - Phone:425-374-8014
Practice Address - Fax:425-903-4361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA325034OtherDEPARTMENT OF LABOR & INDUSTRIES