Healthcare Provider Details
I. General information
NPI: 1972558005
Provider Name (Legal Business Name): OANA MARCU DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/24/2006
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1818 121ST ST SE
EVERETT WA
98208-5985
US
IV. Provider business mailing address
PO BOX 5127
EVERETT WA
98206-5127
US
V. Phone/Fax
- Phone: 425-357-3304
- Fax: 425-357-3317
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OP00002023 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | OP00002023 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: