Basic Information
| Provider Information | |||||||||
| NPI: | 1912340381 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOOTE | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17124 44TH AVE W | ||||||||
| Address2: | APT A201 | ||||||||
| City: | LYNNWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980373107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066618669 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1424 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982011720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4257892000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2013 | ||||||||
| LastUpdateDate: | 10/05/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD00016017 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.