Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD00021837 | WA |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD00021837 | WA |
NPI | 1225198708 |
---|---|
Provider Name | Stephen Peter Markus |
First Address | Kirkland, WA 98033 |
Second Address | Bellevue, WA 98005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 01/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12413 | L & I (01) | WA |
D33718 | (02) | |
G8852801 | (02) |