Basic Information
| Provider Information | |||||||||
| NPI: | 1396894879 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROON | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2940 W MARINE VIEW DR | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982013926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252587014 | ||||||||
| FaxNumber: | 4252587760 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 N BROADWAY STE A3 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982011585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252612000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | MD00017290 | WA | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.