Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DE00010298 | WA |
N | 1223G0001X | General Practice | DE00010298 | WA |
N | 213EG0000X | General Practice | DE00010298 | WA |
NPI | 1144349119 |
---|---|
Provider Name | Dr. Mark Earl Germack |
First Address | Seattle, WA 98101 |
Second Address | Seattle, WA 98101-1853 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 23/08/2017 |