Provider Demographics
NPI:1912340381
Name:FOOTE, NANCY LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LOUISE
Last Name:FOOTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17124 44TH AVE W
Mailing Address - Street 2:APT A201
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-3107
Mailing Address - Country:US
Mailing Address - Phone:206-661-8669
Mailing Address - Fax:
Practice Address - Street 1:1424 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1720
Practice Address - Country:US
Practice Address - Phone:425-789-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016017207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine