Healthcare Provider Details
I. General information
NPI: 1063464139
Provider Name (Legal Business Name): CYNTHIA A MARKUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/17/2006
Last Update Date: 04/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1321 COLBY AVE
EVERETT WA
98201-1665
US
IV. Provider business mailing address
2360 43RD AVE E #113
SEATTLE WA
98112-2788
US
V. Phone/Fax
- Phone: 425-261-2000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | MD00014537 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | MD00014537 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: