Active NPI
Michael Allen Fletcher, SURGICAL FIRST ASSIS
- Other Technician
- Everett, WA
National Provider Identifier
1235376799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 111654
- Practice address
- 3726 Broadway, Suite 201
Everett, WA 98201 - Phone
- (425) 317-9119
- Fax
- (425) 317-9118
- NPI assigned
- Jan 20, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 111654 | WA | Primary |
Addresses
Primary practice location
3726 Broadway, Suite 201
Everett, WA 98201
Mailing address
3726 Broadway, Suite 201
Everett, WA 98201
Phone (425) 317-9119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111654 | WA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232409600000",
"number": "1235376799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3726 BROADWAY, SUITE 201",
"city": "EVERETT",
"state": "WA",
"postal_code": "98201",
"telephone_number": "425-317-9119",
"fax_number": "425-317-9118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3726 BROADWAY, SUITE 201",
"city": "EVERETT",
"state": "WA",
"postal_code": "98201",
"telephone_number": "425-317-9119",
"fax_number": "425-317-9118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLETCHER",
"first_name": "MICHAEL",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "SURGICAL FIRST ASSIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-20",
"last_updated": "2009-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "WA",
"license": "111654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.