Headley, John Lawrence

Headley, John Lawrence is an sole proprietor health care provider with primary practice located at 21600 Highway 99 #280, Edmonds WA 98026-8012. He recently has only one registered license in Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, which is considered as his primary health care specialty. Headley, John Lawrence can be contacted via phone (425) 774-2616.

Contact Information

Primary practice address
21600 Highway 99 #280 Edmonds WA 98026-8012
Phone: (425) 774-2616
Fax: (425) 774-2660
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X MD00018010 Washington

Profile Details

NPI number 1528093861
LBN Legal business name Headley, John Lawrence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528093861 NPPES
Washington MEDICAID 1030683

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