NPI 1356457063 · live from the CMS NPI Registry
Mark David Derleth, M.D.
Internal Medicine, Gastroenterology in Seattle, WA. National Provider Identifier 1356457063, active.
NPI record
| NPI | 1356457063 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Gastroenterology 207RG0100X |
| Practice location | 1959 Ne Pacific St, Box 356424, Seattle, WA 98195 |
| Practice phone | 206-598-4377 |
| Enumerated | August 23, 2006 |
| Last updated | March 18, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine, Gastroenterology primary | 207RG0100X | MD 60022504 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.