Costello, John A

Costello, John A is an individual health care provider with primary practice located at 1135 116Th Ave Ne , Bellevue WA 98004-4604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Costello, John A can be contacted via phone (425) 451-4141.

Contact Information

Primary practice address
1135 116Th Ave Ne Bellevue WA 98004-4604
Fax: (425) 451-4144
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD00032956 Washington

Profile Details

NPI number 1780628610
LBN Legal business name Costello, John A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jul 9th, 2007 - about 17 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 1780628610 NPPES
Washington MEDICAID 8210528
Washington Other 135607

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